“The Flipping Bullet” with Associated Intramedullary Dystrophic Calcification: An Unusual Cause for Migratory Myelopathy and Radiculopathy

Christopher H Hunt*, Gavin A McKenzie, Felix E Diehn, Jonathan M Morris, Christopher P Wood
Mayo Clinic, Department of Radiology Rochester, Minnesota

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open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Mayo Clinic, Department of Radiology 200 First Street SW Rochester, Minnesota 55905; Tel: 507-284-5114; Fax: 507-293-3680; E-mail:


We report the case of a 24 year old male who had a retained bullet within his thoracic spine from a gunshot wound resulting in paraplegia. After 7 months he began experiencing painful dysesthesias at his sensory level. Repeat imaging demonstrated migration of the bullet as well as the development of intramedullary dystrophic calcification associated with the bullet. This case demonstrates not only the ability for retained bullets to migrate within the spinal canal but also demonstrates they can lead to remote symptoms due to the development of dystrophic calcification.

Keywords: Bullet, dystrophic calcification, spinal cord trauma.