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Case 26 - Limbus vertebra

from Section 2 - Spine

Published online by Cambridge University Press:  05 March 2013

By
Joel A. Gross
Edited by
Martin L. Gunn
Martin L. Gunn
Affiliation:
University of Washington School of Medicine
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Summary

Imaging description

A limbus vertebra (LV) demonstrates separation of a segment of the rim of the vertebral body. This was first described by Schmorl in 1927 [1], and is caused by intraosseous penetration of disk material at the junction of the cartilaginous endplate and the bony rim during childhood or adolescence [2]. An oblique radiolucent defect extends from the vertebral endplate to the outer surface of the vertebral body, separating off a small segment of bone (Figure 26.1). In adults, this is typically triangular in shape and has sclerotic margins. This helps distinguish the lesion from an acute fracture. In children, the separate fragment may not be ossified, and not visible on radiographs, and only a lucent defect in the vertebral body may be evident.

Limbus vertebrae most commonly occur at the anterosuperior margin of a single lumbar vertebra [3], followed by the anteroinferior margin of a lumbar vertebra, and far less commonly at the posteroinferior corner of a lumbar vertebra or in the thoracic spine [1].

Type
Chapter
Information
Pearls and Pitfalls in Emergency Radiology
Variants and Other Difficult Diagnoses
 , pp. 90 - 91
Publisher: Cambridge University Press
Print publication year: 2013

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References

Henales, V, Hervas, JA, Lopez, P, et al. Intervertebral disc herniations (limbus vertebrae) in pediatric patients: report of 15 cases. Pediatr Radiol. 1993;23(8):608–10.CrossRefGoogle ScholarPubMed
Resnick, D. Diagnosis of Bone and Joint Disorders. Philadelphia: Saunders; 2002.Google Scholar
Kumar, R, Guinto, FC, Madewell, JE, Swischuk, LE, David, R. The vertebral body: radiographic configurations in various congenital and acquired disorders. Radiographics. 1988 May;8(3):455–85.CrossRefGoogle ScholarPubMed
Yagan, R. CT diagnosis of limbus vertebra. J Comput Assist Tomogr. 1984 Feb;8(1):149–51.CrossRefGoogle ScholarPubMed
Ghelman, B, Freiberger, RH. The limbus vertebra: an anterior disc herniation demonstrated by discography. AJR Am J Roentgenol. 1976 Nov;127(5):854–5.CrossRefGoogle ScholarPubMed
Fardon, DF, Milette, PC. Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine (Phila Pa 1976) 2001:26(5):E93–113. Available from: (accessed January 17, 2012).CrossRefGoogle ScholarPubMed

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