Spine hemangioma seen by chance on a scan

What the report words mean

Typical hemangioma. A spot with a lot of fat. On CT or MRI it shows thick bony stripes, called the "corduroy" sign from the side and the "polka-dot" sign in cross-section. These features make it straightforward to recognise. (Kato 2024)
Atypical hemangioma. A spot with less fat and more blood vessels, so it may not show the classic stripes or dots. It can look like other bone conditions, and a report may suggest more tests to be sure. (Kato 2024)
Aggressive hemangioma. A rare kind that extends beyond the bone and can press on the spinal cord or nerves. Most of these cause symptoms. (Kato 2024)
Type I to IV. Some reports use a newer MRI grouping by signal pattern. Type I is the fat-rich kind and made up 79% of hemangiomas in one study. (Abul-Kasim 2023)

How common it is, by age and sex

A Swedish study of 1,000 people who had a spine MRI found at least one hemangioma in 41%. Most people had one, and some had several. (Abul-Kasim 2023)

Share of people with at least one spine hemangioma on MRI, by group
Group	With a hemangioma
Aged 20 or under	13%
Aged 21 to 40	16%
Aged 41 to 60	46%
Aged over 60	46%
Women	43%
Men	39%
Everyone	41%

The authors found that hemangiomas became more common with age. The gap between women and men was small and not statistically significant in their study. (Abul-Kasim 2023) A review describes a slight female preponderance, about 1 man to 1.5 women. (Kato 2024) Most cause no symptoms: earlier studies put this at 89% to 99%. (Abul-Kasim 2023)

When it matters

Most need nothing. The review says most vertebral hemangiomas cause no symptoms and do not need treatment. (Kato 2024)
Slow growth. In the Swedish study, people were followed with repeat MRI for an average of 7 years. About a quarter of hemangiomas changed size, with an average growth of 0.3 mm a year, and all of them, typical or not, behaved as slow-growing benign spots. (Abul-Kasim 2023)
If you have a cancer history. An atypical hemangioma can look like a cancer spread to bone on some MRI images, so a report may suggest a further scan. (Abul-Kasim 2023)(Kato 2024)
When it causes symptoms. The review says a hemangioma that causes symptoms can give local back pain or, if it presses on the spinal cord or nerves, weakness, numbness or tingling. (Kato 2024)
Seeing a GP. The NHS says to see a GP for back pain that does not improve after a few weeks, stops you doing day-to-day things, comes with weight loss without trying, a lump or swelling or a change in the shape of your back, does not improve with rest or is worse at night, is worse when sneezing, coughing or pooing, or is between the shoulders. (NHS back pain)
Worry is real. See after an abnormal screening result.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 (your local urgent care line elsewhere) if you have back pain and feel hot, cold, shivery or generally unwell, or the pain is severe and starts suddenly or gets worse quickly. It says to call 999 or go to A&E (your local emergency number elsewhere) for back pain with pain, tingling, weakness or numbness in both legs, loss of feeling around the genitals or anus, changes in bladder or bowels, changes in sexual feeling or function, chest pain, or pain after a serious accident. (NHS back pain)

Other things a scan may show

The same scan may mention other chance findings, each with its own page: a disc bulge or wear, another kind of bone spot, low bone density seen on CT and a fatty lump (lipoma).

Who it applies to

Adults told that a spine MRI or CT, or a scan of another body part that included the spine, shows a hemangioma. Children, people already being seen for a spine condition, and a scan done because of back pain, weakness or numbness are outside this page.

Routine age-based screening

A spine finding on a scan does not replace the routine screenings for your age, such as bone density testing. See screenings by age and gender.

Where they differ:

Repeat scans for atypical spots. The Swedish study found that atypical hemangiomas grew as slowly as typical ones and that none of those first reported as possible cancer spread changed in a worrying way on later MRI. Its authors suggest small hemangiomas do not always need to be reported, to avoid unneeded follow-up scans and worry. (Abul-Kasim 2023) A review describes a hospital approach in which radiographically atypical hemangiomas get more tests, such as a biopsy and a PET-CT scan. (Kato 2024)
How common it is. Older autopsy studies found hemangiomas in 11% of adults, and earlier CT and MRI studies in 26% and 27%. The Swedish MRI study found 41% and says modern MRI sees more small ones. (Abul-Kasim 2023)
Women and men. The review describes slightly more hemangiomas in women. (Kato 2024) In the Swedish study the difference was small and not significant. (Abul-Kasim 2023)

Your doctor decides what your result means for you.

Questions people ask

Is a hemangioma in the spine cancer?

No. A vertebral hemangioma is a benign (not cancer) growth of small blood vessels inside a bone of the spine. A review calls it the most common benign tumour of the spine and says it is often found by chance on a scan. (Kato 2024)

How common is a spine hemangioma?

Very common. In a study of 1,000 people who had a spine MRI, 41% had at least one. It was found in 13% of people aged 20 or under, 16% at 21 to 40 and 46% in people over 40. (Abul-Kasim 2023)

What does "typical" or "atypical" hemangioma mean on a report?

A typical hemangioma has a lot of fat and shows a classic striped or dotted pattern on CT or MRI. An atypical one has less fat and more blood vessels, so it can look like other bone conditions and may need more tests to be sure. Your doctor decides what your result means for you. (Kato 2024) (Abul-Kasim 2023)

Does a spine hemangioma grow?

Usually very slowly, if at all. In people followed for an average of 7 years, about a quarter of hemangiomas changed size, with an average growth of 0.3 mm a year, and all behaved as slow-growing benign spots. (Abul-Kasim 2023)

When should I get help for back pain?

The NHS says to call 999 or go to A&E for back pain with pain, tingling, weakness or numbness in both legs, loss of feeling around the genitals or anus, or changes in bladder or bowels. It lists other signs that need a GP or urgent help. (NHS back pain)