Abstract

BOLIVAR-ROLDAN, Isabel; GARCIA-GOMEZ, Francisco Javier; RIVA-PEREZ, Pablo Antonio de la  and  CALVO-MORON, María de la Cinta. Kummel's disease. Rev.Colomb.Reumatol. [online]. 2022, vol.29, n.4, pp.350-353.  Epub Aug 15, 2023. ISSN 0121-8123.  https://doi.org/10.1016/j.rcreu.2020.11.002.

Kummel's disease is a crush fracture of a vertebral body caused by a minor trauma, with the most accepted etiology being avascular necrosis. It is more frequent in individuals with risk factors such as osteoporosis or prolonged treatment with corticosteroids. Initially, it usually has normal radiological tests and an asymptomatic period, followed by a progressive onset of pain along with probable kyphosis and a sign of void or fluid abscess on radiological tests, which may create nerve/spinal involvement. The case is presented of a 76-year-old man, who was admitted to this center for the differential diagnosis of a single vertebral lesion. After imaging tests and biopsy, the definitive diagnosis of Kummel's disease was reached. The confirmatory diagnosis was reached by vertebral biopsy, but given its invasive nature, imaging techniques can play a significant role. As regards metabolic imaging tests, bone scintigraphy has shown to be one of the most sensitive tools to detect ischemia in earlier stages or to determine if it affects other locations. The whole body scan with diphosphonates shows an increase in activity in relation to bone remodeling activity in this condition. The 3-phase study makes it possible to differentiate whether it is an acute/subacute or chronic process, and can influence the therapeutic decision. Knowledge of this disease is important to make a differential diagnosis with tumour or infectious pathology, with emphasis on performing imaging tests in the event of persistent pain with a normal initial plaque.

Keywords : Kummel's disease; Avascular necrosis; Vertebral body; Bone scintigraphy; Nuclear medicine.

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