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. 2014 Mar 4;9:69. doi: 10.1186/1748-717X-9-69

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Copyright © 2014 Fisher et al.; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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A 67-year-old man with known metastatic small cell lung cancer presents with interscapular back pain that is exacerbated by movement and relieved with rest. Computed Tomography (CT) (A: left parasagittal, B: midline parasagittal, C: right parasagittal, D: coronal, and E: axial) and Magnectic Resonance (MR) images (F: sagittal, T2-weighted) outline the key details of this T5 lesion. Total SINS score = Semirigid (T5) spine, 1 point; ‘Mechanical’ pain (yes), 3 points; Lytic lesion, 2 points; De novo kyphotic deformity without subluxation/translation, 2 points; >50% vertebral body collapse, 3 points; and bilateral posterolateral spinal element involvement, 3 points. Total SINS score = 1 + 3 + 2 + 2 + 3 + 3 = 14 (unstable, surgical consultation is recommended).