There are several findings in these radiographs:

1. Kyphosis in the thoracic spine with a density over a vertebral body (T6).
   (Red arrow)
2. A similar density is seen in the mediastinum (white arrows) in both, the PA and lateral CXR.

a-CT (MIP) densities are see in the right upper lobe artery (Red arrow) as well as in the peripheral vasculature and in the venous plexus of the spine (Green arrow) .

b- CT, lung window settings shows densities in the right ventricle ( Yellow arrows).

The densities are produced by cement introduced in the vertebral body

 (Vertebroplasty).) Figure 1a). A possible complication of vertebroplasty is the pulmonary embolization of cement

Vertebroplasty has few complications (Less that 2%) and usually are related to extravasation of the cement either into the epidural space, with possible neurological consequences, or to the venous plexus.  When this occurs emboli will travel to the lungs.

Kyphoplasty, an alternative technique, has fewer extravasations according to the literature ( VERTOS multicentric study) The reason is that in kyphoplasty the intravertebral cement is “sealed”. (Figure 1b).

Echevarria. titulo-vertebroplastia-y-cifoplastia.html

Main points:

1. Techniques to treat osteoporotic fractures by the use of cement materials are very useful and safe, but may produce embolization to the epidural structures and venous plexus. Pulmonary embolism occurs in this last case and is usually not symptomatic. I the case of large embolization symptoms of acute PE occur.
2. Look for calcific densities in the pulmonary vessels associated to a vertebra with cement in the body and probably nearby spills.

Congratulations to Amar who made the diagnosis immediately.