Clinical History: 12 year old boy with back pain limiting activities of daily living

Diagnosis: Thoracic vertebral eosinophilic granuloma

MR Technique:

Thoracic spine imaging was performed on a 3T MR system (Skyra, Siemens). (A) Sagittal T1-weighted TSE (TR/TE 650/8.1ms) and (B) T2-weighted TSE (TR/TE 2000/97ms) images were acquired. Contrast-enhanced sagittal T1-weighted (C) and coronal T1-weighted images (D) were also obtained utilizing the Dixon technique for fat saturation.

Imaging Findings:

Severe loss of T3 vertebral body height (i.e. vertebral plana) is present with preservation of the adjacent disk space. The affected vertebral body demonstrates low signal intensity on T1WI and slightly increased signal intensity on T2WI compared to the normal bone marrow. Contrast-enhanced MR imaging demonstrates associated enhancement of the vertebral lesion and of the extensive paravertebral soft tissue present. The most common cause of vertebra plana in children is Langerhans cell histiocytosis (LCH), of which eosinophilic granuloma is the unifocal variant.