Prepared by Paul B. DiDomenico, MD, Radiology Resident, Jeffrey P. Tan, MD, Radiology Resident, and Michael A. Tall, MD, Staff Radiologist, Radiology Department, David Grant US Air Force Medical Center, Travis Air Force Base, Calif

An 80-year-old woman was admitted to the internal medicine service after a mechanical fall at home. She had a history of chronic low back pain. Her functional status had been declining at home despite maximal medical therapy for pain.

Magnetic resonance imaging (MRI) (with fat saturation) of her lumbar spine was performed. A sagittal T2-weighted MRI scan (Figure 1) and a coronal T1-weighted postgadolinium MRI scan (Figure 2) are shown.

What’s Your Diagnosis?
Osteoporosis with compression fracture

Metastatic disease

Spondylitis with paraspinal abscess

Hemodialysis-related arthropathy