This 56 years old man was referred for a CT guided biopsy on the basis of an MRI report of an osteolytic lesion at D10 with abnormal soft tissue.
The MRI showed a fracture extending from the anterior to the posterior elements. I then looked at the radiographs, which showed frank ankylosing spondylitis.
This has never been picked up. The patient effectively had a fracture through D10, essentially a pseudarthrosis / Andersson lesion and he did not need a biopsy.