Case Author(s): Samuel Wang, M.D. and Jerold Wallis, M.D. , 9/22/96 . Rating: #D3, #Q3

Diagnosis: Spinous process contusions/fractures.

Brief history:

40-year old woman who fell from a horse approximately seven weeks ago and now has complaints of back pain.


Anterior and posterior whole body images.

View main image(bs) in a separate image viewer

View second image(bs). SPECT sagittal images.

Full history/Diagnosis is available below

Diagnosis: Spinous process contusions/fractures.

Full history:

This 40-year old woman fell from a horse approximately seven weeks prior to this examination. She landed "flat on her back" and has had persistent complaints of thoracolumbar back pain.


Tc-99m MDP


The whole-body planar images demonstrate mildly increased radiopharmaceutical uptake in the spinous processes of T7-11. This is seen much more clearly on the sagittal SPECT reconstructed images. Additionally, there is moderately increased uptake in the T7 vertebral body. The spinous processes were not well visualized on plain films although mild anterior compression of the vertebral body of T7 was noted.


Given the mechanism of injury and the appearance of consecutive foci of uptake, these findings are most consistent with contusion and/or fractures of the spinous processes of T7-11 as well as compression fracture of T7. Increased uptake in the posterior spinous processes was quite subtle on the original film version of the planar images, though it can be seen on careful examination of the digital images shown here. Oblique planar images or SPECT both can improve visualization of this site.

ACR Codes and Keywords:

References and General Discussion of Bone Scintigraphy (Anatomic field:Skeletal System, Category:Effect of Trauma)

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Case number: bs064

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