VCS-vacuum cleft sign

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1. The intravertebral vacuum cleft sign (VCS) is an uncommon radiological sign.
2. VCS is characterized by a radiolucent zone in the vertebral body.
3. This zone is composed of 95% nitrogen and small amounts of oxygen and carbon dioxide.

4. Cause:

a. Post-traumatic ischemic necrosis (main cause) but other causes are (point b onwards)
b. osteoporosis,
c. corticosteroid therapy,
d. diabetes,
e. arteriosclerosis,
f. alcoholism,
g. multiple myeloma,
h. bone metastasis and
i. osteomyelitis.

The broad diagnosis is made by AP X-ray. However DD encompasses CT scan and MRI.

Reference:

Sarli M et al; Osteoporos Int. 2005 Oct;16(10):1210-4. Epub 2005 Feb 25.

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