The Winking Eye

pedicle metastasis plain film

The normal verebral body on AP projection has ‘2 eyes’ due to the pedicles symmetric about the central spinous process.

In pedicle destruction, most commonly due to a lytic metastasis, one of the eyes is lost giving the impression of winking at the observer/interpreter.

In this case the bony metastasis was secondary to a primary bronchial carcinoma.

Reference: Imaging the Acutely Ill Patient, Kelly, Saunders.

Credit: Dr Ian Bickle