History: A 62-year-old woman presents with neck pain.
A CT scan was performed. Magnified axial, coronal, and sagittal images of the lower cervical spine are shown below.
CT demonstrates a focus of air within a lower cervical spine vertebral body that is completely contained within the vertebral body and does not appear to communicate with the disk space.
- Intravertebral pneumatocyst
- Schmorl\’s node
- Infection with gas-forming organism
Diagnosis: Intravertebral pneumatocyst
Intravertebral pneumatocysts are benign, gas-filled cystic lesions that occur within bone. Although they can occur in a variety of different locations, in the spine they most often occur in the cervical region. The etiology of these lesions is unknown, though their relation to degenerative change is likely.
Although these lesions were initially thought to be rare, subsequent studies have shown that they occur relatively frequently (present in up to 40% of patients undergoing cervical spine CT, with postsurgical and trauma patients excluded).
The lesions are considered benign, and no specific treatment is required.