A 67-year-old woman with low energy trauma. Radiograph (A) shows T12 vertebra deformity, upper and lower endplate depression, as well as anterior cortex bulging (swelling). T12 vertebra shows mixed high signal on fat suppressed T2 weighted MR image (B) and mixed low signal on T1 weighted MR image (C). Note anterior cortex swelling is a risk factor for OVF further progress. OVFs associated with low energy trauma commonly show anterior cortex bulging, break, or buckling. OVF, osteoporotic vertebral fracture; MR, magnetic resonance.