It is often difficult for clinicians to diagnose osteoporotic fresh compression vertebral fracture on X-ray of patients with spondylosis deformans and multiple old compression fractures. To prevent neurological compromise due to delayed vertebral collapse after fracture, the initial diagnosis and therapy are very important. Magnetic resonance imaging (MRI) is very sensitive for detecting these fractures. T1 weighted images with low signal intensity are more sensitive than T2 weighted images with high signal intensity.
We retrospectively studied the T1 weighted images of 48 fresh fractures in 45 patients. Fractures were classified into two types from biomechanical studies. In type A, the range of low intensity was in the anterior column on para-sagittal images, and these images showed little collapse and patients had good outcome. In type M, the range of low intensity reached to the middle column, and images often showed collapsed vertebrae. Type M patients should be carefully treated.
Initial MRI diagnosis of osteoporotic vertebral compression fracture is very useful for deciding therapeutic strategy.
