Table 2 Radiological interpretation of new versus old vertebral fracture
Findings | New fracture | Old fracture |
|---|---|---|
Morphometry | Altered, e.g. wedge shape and/or depression in endplate | Altered, e.g. wedge shape and/or depression in endplate |
Fracture line | Present, may be difficult to identify | Absent, be aware of incomplete healing with pseudo-joint |
Step-defect | Present, with characteristic demarcation of edges | Absent, healed step-defects have smoothened edges |
Zone of impaction | Present, reactive sclerosis in proximity to the fracture site | Absent, sclerosis of endplates due to degenerative changes may be widespread |
Bone marrow edema | Present, not visible on conventional X-rays. Evident on MRI | Absent |
Paraspinous hematoma | Often present, not visible on conventional X-rays. Evident on MRI | Absent |
Callus formation | Typically present within the first 2–4 weeks. Then, callus is gradually removed | Absent |
Remodeling of bone | Absent | Often present as residual findings following old, healed fracture |