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AJR 2004; 182:1600
© American Roentgen Ray Society

Regarding "Fish" or "Fish Mouth" Vertebrae

Michael E. Mulligan

University of Maryland Medical School Baltimore, MD 21201

A recent letter to the editor by Rexroad et al. [1] reveals some confusion on the part of radiology residents regarding one of the classic radiologic signs, the fish vertebra sign. The exact origin of this sign is not known, but the following quote from Jack Reynolds' 1966 article [2] may shed some useful light:

[I]t was probably introduced by a Boston radiologist who, influenced by provincial pisciculture and local dietary customs, used the species-specific phrase "codfish vertebra."

Reynolds was writing about the H-shaped vertebral body deformities seen in patients with sickle cell disease. He made it clear that vertebral body deformities, whether H-shaped or "fish" type, referred to the vertebral end-plates and not the intervening space (the intervertebral disk space).

I agree with Rexroad et al. [1] that the configuration of the disk space may resemble a fish mouth, but as their own specimen radiograph shows, it is the biconcave appearance of a fish vertebral body to which the sign refers.

References

  1. Rexroad JT, Moser RP III, Georgia JD. "Fish" or "fish mouth" vertebrae? (letter) AJR2003; 181:886 –887[Free Full Text]
  2. Reynolds J. A re-evaluation of the "fish vertebra" sign in sickle cell hemoglobinopathy. AJR1966; 97:693 –707[Abstract/Free Full Text]

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