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Lytic Lesion in a Cervical Vertebra

Donald J. Fleischli, MD
JAMA. 1967;201(3):192-193. doi:10.1001/jama.1967.03130030062015.
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Dr. S. Boyd Eaton: A 16-year-old girl gave a nine-month history of intermittent, nonradiating, dull pain localized in the upper part of her neck. Two days prior to admission the pain increased in severity quite suddenly and she sought medical attention. She denied associated neurological symptoms, exposure to tuberculosis, and previous trauma. Abnormal physical findings were limited to the neck where marked spasm and loss of the normal cervical lordosis were noted. Findings from neurological examination were normal. Laboratory data for hematocrit reading, white blood cell count, urinalysis, and serum calcium, phosphorus, and alkaline phosphatase levels were normal. Corrected erythrocyte sedimentation rate was 16 mm in one hour. Intradermal skin test for tuberculosis was negative. Roentgenograms of the cervical spine were obtained (Fig 1 and 2).

Discussion  Dr. Laurence L. Robbins: Dr. Hanelin, what is your opinion of this case?Dr. Joseph Hanelin: There is a destructive lesion in the


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