Question

Picture frame vertebra is seen in which of the following?

• A. Paget's disease
• B. Osteopetrosis
• C. Osteoporosis
• D. Ankylosing spondylitis

Hint:

The remodelling disease that also gives ivory vertebra and cotton wool skull.

Answer 1

The Correct Option is A

Step 1: Paget's disease of bone is a disorder of disordered bone remodelling with phases of excessive resorption followed by chaotic new bone formation.

Step 2: In the later sclerotic phase affecting a vertebra, there is marked cortical thickening of the superior and inferior end plates along with the peripheral cortex. This thickened rim around a less dense centre gives the classic picture frame vertebra appearance, making Paget's disease the answer.

Step 3: Other characteristic Paget signs include the ivory vertebra (uniformly dense vertebra), candle flame or blade of grass lucency in long bones, osteoporosis circumscripta and cotton wool skull on cranial films.

Step 4: Osteopetrosis produces a uniformly dense bone within bone or sandwich vertebra, osteoporosis causes a lucent vertebra with a pencilled cortex, and ankylosing spondylitis gives squaring and a bamboo spine, none of which is the picture frame vertebra.