The butterfies' vertebra-diagnostic difficulties - case report

Area of Science:

• Orthopedics
• Radiology
• Rehabilitation Medicine

Background:

• Congenital vertebral anomalies, such as hemivertebrae, account for a significant portion of spinal defects.
• These anomalies can often be incidentally discovered during the investigation of spinal pain or neurological issues.

Purpose of the Study:

• To present a case study of a patient with spinal pain initially diagnosed with a pathologic vertebral fracture.
• To highlight the importance of advanced imaging in diagnosing congenital spinal defects when clinical presentation and initial radiological findings are discordant.

Main Methods:

• Clinical evaluation of a 47-year-old male physical worker with spinal pain.
• Initial diagnostic imaging (radiography) revealing a suspected pathologic fracture of the T10 vertebra.
• Advanced diagnostic imaging (3D CT scan) to further investigate the discrepancy between radiological findings and neurological status.

Main Results:

• 3D CT scan identified a developmental defect of the spine (hemivertebra) as the underlying cause, not a pathologic fracture.
• The patient's condition improved following a tailored diagnostic and rehabilitation process.
• Principles for ongoing management and future procedures were established.

Conclusions:

• Hemivertebrae are a notable cause of spinal issues and require thorough diagnostic evaluation.
• Integrating advanced imaging like 3D CT is crucial for accurate diagnosis of spinal anomalies in rehabilitation settings.
• Standardizing diagnostic verification for congenital spinal defects in rehabilitation is recommended for national health frameworks.