Winking owl sign - vertebral metastases are common in oncology patients. A reliable sign of osteolytic spinal metastases on AP radiographs is loss of the normal pedicle contour. The appearance of unilateral pedicle absence has been likened to that of a winking owl with the missing pedicle being the closed eye, the contralateral pedicle being the open eye and the spinous process being the beak. In the above example a metastasis has obliterated the left pedicle at T11. The T12 pedicles are outlined as a reference point.
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