The Spine Journal 15 (2015) 1903
The rugger jersey spine sign
References
A 35-year-old male patient presented to our hospital with complaints of abdominal pain with dysuria and hematuria. The physical examination was normal. The laboratory findings showed hypercalcemia and erythrocytes in the urine. In addition, the parathormone levels were increased. The diagnosis of hyperparathyroidism was made according to these findings. Direct urinary system radiography was performed to identify the urinary calculi. Because direct urinary system radiography detected sclerotic areas of the vertebral bodies, thoracolumbar spine radiography and computed tomography examinations were performed. The sclerotic areas were detected in superior and inferior end plates of the vertebral bodies. The imaging findings were consistent with the rugger jersey spine sign (Figure, Left and Right). In radiographs, the severe accumulation of osteoid appears more radiopaque than normal bone, and this appearance results in the classic rugger jersey spine sign. The sclerotic and lucent bands along the inferior and superior end plates of vertebral bodies are similar to the stripes on an English rugby shirt [1,2]. This entity is considered a diagnostic clue of osteosclerosis and usually occurs as a sign of hyperparathyroidism. Osteopetrosis and Paget disease should be considered in the differential diagnosis.
[1] Wittenberg A. The rugger jersey spine sign. Radiology 2004;230: 491–2. [2] Lacativa PG, Franco FM, Pimentel JR, Patrıcio Filho PJ, Gonc¸alves MD, Farias ML. Prevalence of radiological findings among cases of severe secondary hyperparathyroidism. Sao Paulo Med J 2009;127:71–7.
Ibrahim Guler, MDa Mustafa Koplay, MDa Alaaddin Nayman, MDa Ali Sami Kivrak, MDa Ismet Tolu, MDb a Department of Radiology Selcuk University Faculty of Medicine Konya 42075, Turkey b Department of Radiology Konya Research and Education Hospital Konya, Turkey FDA device/drug status: Not applicable. Author disclosures: IG: Nothing to disclose. MK: Nothing to disclose. AN: Nothing to disclose. ASK: Nothing to disclose. IT: Nothing to disclose.
Figure. Lateral radiograph (Left) and sagittal reformatted computed tomography (Right) images of the thoracolumbar region show bandlike regions of increased opacity at the superior and inferior margins of the vertebral bodies (arrows). http://dx.doi.org/10.1016/j.spinee.2015.04.020 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
The rugger jersey spine sign
References
A 35-year-old male patient presented to our hospital with complaints of abdominal pain with dysuria and hematuria. The physical examination was normal. The laboratory findings showed hypercalcemia and erythrocytes in the urine. In addition, the parathormone levels were increased. The diagnosis of hyperparathyroidism was made according to these findings. Direct urinary system radiography was performed to identify the urinary calculi. Because direct urinary system radiography detected sclerotic areas of the vertebral bodies, thoracolumbar spine radiography and computed tomography examinations were performed. The sclerotic areas were detected in superior and inferior end plates of the vertebral bodies. The imaging findings were consistent with the rugger jersey spine sign (Figure, Left and Right). In radiographs, the severe accumulation of osteoid appears more radiopaque than normal bone, and this appearance results in the classic rugger jersey spine sign. The sclerotic and lucent bands along the inferior and superior end plates of vertebral bodies are similar to the stripes on an English rugby shirt [1,2]. This entity is considered a diagnostic clue of osteosclerosis and usually occurs as a sign of hyperparathyroidism. Osteopetrosis and Paget disease should be considered in the differential diagnosis.
[1] Wittenberg A. The rugger jersey spine sign. Radiology 2004;230: 491–2. [2] Lacativa PG, Franco FM, Pimentel JR, Patrıcio Filho PJ, Gonc¸alves MD, Farias ML. Prevalence of radiological findings among cases of severe secondary hyperparathyroidism. Sao Paulo Med J 2009;127:71–7.
Ibrahim Guler, MDa Mustafa Koplay, MDa Alaaddin Nayman, MDa Ali Sami Kivrak, MDa Ismet Tolu, MDb a Department of Radiology Selcuk University Faculty of Medicine Konya 42075, Turkey b Department of Radiology Konya Research and Education Hospital Konya, Turkey FDA device/drug status: Not applicable. Author disclosures: IG: Nothing to disclose. MK: Nothing to disclose. AN: Nothing to disclose. ASK: Nothing to disclose. IT: Nothing to disclose.
Figure. Lateral radiograph (Left) and sagittal reformatted computed tomography (Right) images of the thoracolumbar region show bandlike regions of increased opacity at the superior and inferior margins of the vertebral bodies (arrows). http://dx.doi.org/10.1016/j.spinee.2015.04.020 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
