Housing prices withered on the vine during the first quarter of 2009, despite signs of the first "green shoots" of recovery elsewhere in the moribund U.S. economy.

The price of homes sold in the first quarter fell 13.8 percent when compared with the first quarter of 2008, according to the National Association of Realtors quarterly survey. It was the largest year-over-year drop in the survey's history and marked the 11th straight quarter sales prices have fallen.

Of the 152 metro areas surveyed, 134 -- or 88 percent -- registered year-over-year price declines. Price gains were limited to just 18 metro areas.

The national median existing single-family home price now stands at $169,000.

Foreclosures and short sales accounted for nearly half of all transactions in the first quarter, a trend that pushed prices lower. Such homes typically fetch prices about 20 percent lower than traditional sales, according to the NAR.

Fifteen metro areas experienced year-over-year declines of at least 30 percent. For the second straight quarter, the Cape Coral-Fort Myers area of southwest Florida recorded the biggest slump, plummeting 59.1 percent. Since 2006, median prices in the region have cratered, falling from $268,200 to $87,300.

Other major decliners in the first quarter included Saginaw-Saginaw Township North, Mich. (-53.7 percent); Akron, Ohio (-48 percent); San Francisco-Oakland-Fremont, Calif. (-42.7 percent); San Jose-Sunnyvale-Santa Clara, Calif. (-42.3 percent); Phoenix-Mesa-Scottsdale, Ariz. (-41.9 percent) and Sarasota, Bradenton-Venice, Fla. (-40.8 percent).

Regionally, price drops were sharpest in the West (-19.8 percent), followed by the Northeast (-15.9 percent), the South (-10.8 percent) and the Midwest (-6.8 percent).

Fifteen U.S. metro areas recorded year-over-year price declines of at least 30 percent in the first quarter of 2009.