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.
a. Post-traumatic ischemic necrosis (main cause) but other causes are (point b onwards)
c. corticosteroid therapy,
g. multiple myeloma,
h. bone metastasis and
The broad diagnosis is made by AP X-ray. However DD encompasses CT scan and MRI.
Sarli M et al; Osteoporos Int. 2005 Oct;16(10):1210-4. Epub 2005 Feb 25.