Chance finding on a 65-year-old-male of well defined very radiolucent region 3 mm wide in C3 and a similar one in C4.

Although not completely understood, some authors believe it is an extension from the intradiscal gas (vacuum phenomenon) 1. On follow up, these lesions changed to fluid-filled cavities and became granulation tissue later on 2. Some of these lesions enlarged in size 1.

Management: Follow up to detect any increase in the size is advised but usually no specific treatment is needed.

References
1. Kitagawa T, Fujiwara A, Tamai K et-al. Enlarging vertebral body pneumatocysts in the cervical spine. AJNR Am J Neuroradiol. 2004;24 (8): 1707-10. Pubmed citation
2. Yamamoto T, Yoshiya S, Kurosaka M et-al. Natural course of an intraosseous pneumatocyst of the cervical spine. AJR Am J Roentgenol. 2002;179 (3): 667-9. doi:10.2214/ajr.179.3.1790667 – Pubmed citation


Douglas K Benn DDS, PhD, Dipl. Dental Radiology (Royal College of Radiologists, England)
Oral and Maxillofacial Radiologist

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