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FIG 1. Images of a 40-year-old man who experienced axial loading injury when thrown from a car and who presented with nonradiating lumbar pain and tenderness directly over the L3 and L5 vertebral bodies.
A, Sagittal midline short inversion time inversion recovery (1400/15/2) image, obtained during the initial MR examination, shows vertebral body edema and mild compression of the superior surfaces of the L3 and L5 vertebral bodies, but no SN is present at either level. Both levels are consistent with simple endplate fractures. Note the smooth superior surface of vertebral bodies L3 and L5, with what appear to be intact cortical margins (straight arrows). The inferior endplate of L5 may also be slightly compressed (curved arrow).
B, Sagittal gradient-echo (450/12/1) MR image, obtained 2 months later when the patient experienced some but not complete resolution of pain and tenderness, shows that a chronic SN formed at the superior endplate of L5 (curved arrow). Note resolution of marrow edema at L5 with persistent but improved edema of L3 (straight arrow). Further follow-up did not show SN formation at L3. This case illustrates that some endplate fractures may evolve into SNs and some may not.
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