Magnetic resonance imaging has established a role in diagnostic work up of patients presenting with various spinal pathologies. DWI is a powerful adjunct to routine magnetic resonance evaluation, providing confidence in lesion detection and tissue characterization. Our present study focuses on diagnostic accuracy of diffusion weighted imaging technique in detection and characterization of traumatic versus pathological fractures using apparent diffusion coefficient maps..In this prospective study of 25 people, there were 13 malignant fracture/infiltration, 12 benign fractures . The malignant fracture/infiltration cases had low mean ADC value of 0.6 x 10-3mm2/s with restriction on DWI+ADC. A mean ADC value of 1.57 x 10-3mm2/s was seen in benign fractures cases with no obvious restriction .A diagnostic accuracy of 88% in malignant vs benign fractures was obtained. We conclude that DWI sequence with ADC mapping when added to routine array of MRI spine with analysis of DW images(qualitative study) and ADC values(quantitative study) enhanced the effectiveness and accuracy of MRI in the differentiation of benign vs malignant fractures
