Intravertebral vacuum cleft sign: a cause of vertebral cold defect on bone scan

A 67-year-old female presented with an acute compression fracture with an intravertebral vacuum cleft (IVC) sign of the T12 vertebra. Her bone scan demonstrated a cold defect of the fractured vertebra. Although the IVC sign is related to vertebral osteonecrosis, to the best of our knowledge, a cold defect on a bone scan has not been reported in an acute compression fracture with an IVC sign. In this case review, various imaging findings of osteonecrotic compression fractures are discussed along with a review of the current literature.