Hemangioma, a rare cause of photopenic lesion on skeletal imaging

In searching for disease on skeletal images it is important to identify areas of increased activity and cold lesions, which are usually more difficult to identify. Focal photon-deficient lesions are due to metastatic disease in over 80% of cases. They may occur if the tumor is extremely aggressive, if there is disruption of the blood supply to the bone, or if there is significant marrow involvement, particularly in a vertebral body. Some of the common causes of a photopenic lesion are avascular necrosis, malignant bone tumors such as multiple myeloma, metastasis, radiation therapy, attenuation artifacts such as prosthesis or pacemaker, and early osteomyelitis. A case of hemangioma of the dorsal vertebra, a rare cause of photopenic lesion, is reported here.