Symptomatic pathological fracture of odontoid as the primary presentation of multiple myeloma: Evaluation by 3D CT, conventional MR imaging, and in-phase and opposed-phase MR technique

Odontoid fractures commonly occur as a result of traumatic cervical spine injuries; pathological fractures being distinctly uncommon. Malignant tumors involving atlanto-axial spine are uncommon, metastases remain a common cause of pathological fractures at this site. Although, myeloma deposits in the cervical spine often occur, primary presentation of multiple myeloma with pathological fracture of odontoid consequent to such deposits is extremely rare. The above feature and its occurrence at an unusual site are the highlights of this report. A short review of the available literature has also been done. We further describe the utility of in-phase and opposed-phase imaging in differentiation of benign from malignant vertebral fracture in context to the present case.