A wiry transfer

This man in his 90s with back pain was found to have compression fractures in the thoracic spine and subsequently underwent vertebroplasty with bone cement injection. At routine follow-up two months later, lateral chest radiography showed a new wire-like radio-opaque density that appeared to originate from the bone cement in the spine (figure, top arrow) and coil near the heart (bottom arrow). Computed tomography confirmed a bone cement pulmonary embolism due to migration of the material from the vertebroplasty site into the pulmonary artery. The patient had no associated shortness of breath or chest pain. Bone cement pulmonary embolism is a recognised complication of vertebroplasty that may occur asymptomatically.