What causes vertical striations in the vertebral body on radiographs and cross-sectional imaging of the spine? (corduroy sign)
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The corduroy sign is a characteristic radiological finding of vertebral hemangioma, a benign vascular proliferation of the spine. Vertebral hemangiomas are the most common benign tumors of the spine and are typically discovered incidentally. The underlying pathological process involves a vascular malformation composed of newly formed normal blood vessels that causes remodeling of the vertebral body architecture. This results in osteolysis of cancellous bone with its replacement by coarse, sclerotic trabeculae. The vertebral body maintains its normal shape and size without pathological collapse. While most vertebral hemangiomas remain asymptomatic, approximately 1 percent of cases can become locally aggressive and present with neurological complications requiring surgical intervention.
Why is it called so?:
The sign is named for its visual resemblance to corduroy fabric or corduroy cloth. The thickened vertical trabeculae appear as vertical stripes or wales similar to the ridged pattern seen in corduroy textile material. The sign is most readily appreciated on lateral radiographs and sagittal imaging views where the vertical striations become visually prominent.
Pathophysiology:
Vertebral hemangiomas are thought to represent a congenital vascular malformation of blood vessels with uncertain etiology. The vascular proliferation causes displacement of normal bone and replacement of cancellous bone with coarse, sclerotic trabeculae surrounded by fatty marrow or vascular spaces. Horizontal trabeculae deteriorate while vertical trabeculae become thickened and accentuated. This architectural remodeling of the vertebral body creates the characteristic striated appearance on sagittal and coronal imaging. The relative radiolucency of the affected vertebral body results from replacement of dense bone with vascular tissue and fat.
Alternative names:
The sign is also referred to as the striated vertebra or jail bar sign.
Other associated named signs:
The polka-dot sign is the axial equivalent of the corduroy sign, appearing as small sclerotic dots on axial computed tomography or magnetic resonance imaging due to the thickened vertical trabeculae seen end-on against a hypodense background.
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