Segmental Bulge of the Linear Thoracic Paraspinal Shadow (Paravertebral Line)

An Early Sign of Disease of the Thoracic Spine

¹ Department of Radiology, Hospital for Joint Diseases, New York

1. Greater attention should be placed upon the finding, on roentgenograms, of the segmental bulge of the linear paraspinal shadow as an indication of disease of the thoracic spine. The paravertebral line is readily seen on the anteroposterior roentgenogram of the thoracic spine and is often apparent on the frontal roentgenograms of the chest.

2. A segmental paraspinal bulge with associated destruction of the disc space almost invariably indicates an underlying infection—most frequently, tuberculosis.

3. If the interspace is normal, the most probable diagnosis is that of a tumor. In my series, metastatic lesions were more frequent than primary lesions.

4. Recent trauma or collapse should be considered in vertebral fractures if there is a bulge of the paravertebral line. The bulge indicates the presence of a hematoma and disappears within one month of the time of injury.

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