Bullets

 

There are bullets, which are black hole artifacts over L3 and L4. Because the internal artifacts overly bone, they are removed from analysis.

Case Description:

There are bullets overlying L3 and L4. The bullets are made of lead and in the dual-energy mode they appear black and are called black hole artifacts. If they are viewed in single energy, they would be white.

Credit:

Sarah L Morgan, MD, RD, CCD, The University of Alabama at Birmingham

References:

• Morgan, S.L., et al., Black hole artifacts-a new potential pitfall for DXA accuracy? J Clin Densitom, 2008. 11(2): p. 266-75.
• Morgan, S.L., et al., More on the black hole: tantalum, stainless steel, titanium, and lead J Clin Densitom, 2007. 10(2): p. S202-S203
• Morgan, S.L., et al., Effect of very dense artifacts on Hologic and General Electric bone densitometry results. . Arch Osteoporos 2020. 15(1): p. 77.