A case report of ivory vertebra sign: an initial radiological manifestation of underlying abdominal malignancy.

Low back pain is one of the most common presenting complaints in the emergency department, and a plain radiograph of the lumbar spine is usually the first diagnostic modality. The ivory vertebra sign refers to the radiological appearance of a smooth, white ivory-like appearance of the affected single vertebra or multiple vertebral bodies. It is sometimes the initial radiologic manifestation of a variety of infectious, neoplastic, or metabolic diseases. Subsequent computerized tomography and magnetic resonance imaging are generally indicated to characterize the details, as well as look for other occult lesions. It is therefore important for emergency physicians to be aware of this, as this will aid in the appropriate evaluation and rapid diagnosis of the underlying disorder.