Imaging features of tumor-related versus osteoporotic vertebral fractures

Vertebral collapse after minor trauma in elderly osteoporotic patients can be difficult to distinguish from vertebral tumor fracture. We present the case of a 74-year-old female patient with lower back pain and functional impairment. The initial differential diagnosis included an osteoporotic vertebral fracture. CT and MRI examination revealed a tumor- related vertebral compression fracture at L1 level. The histopathological diagnosis was micronodular IgG kappa multiple myeloma. Systemic chemotherapy and lumbar radiotherapy were initiated. Imaging was essential for evaluating vertebral morphology and characterizing the lesion, as well as for guiding the therapeutic management.