Pathophysiology and MRI Findings of Infectious Spondylitis and the Differential Diagnosis
On MRI, abnormal signals of the intervertebral disc, destruction of the upper and lower vertebral body endplate around the disc, and bone marrow edema around the endplate are considered typical findings of infectious spondylitis. These findings can also appear in various non-infectious spinal dis...
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| Main Authors: | , , , , , |
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| Format: | article |
| Language: | EN KO |
| Published: |
The Korean Society of Radiology
2021
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| Subjects: | |
| Online Access: | https://doaj.org/article/96ca3e8748b94f48955ecbd42b76d6f7 |
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| Summary: | On MRI, abnormal signals of the intervertebral disc, destruction of the upper and lower vertebral
body endplate around the disc, and bone marrow edema around the endplate are considered
typical findings of infectious spondylitis. These findings can also appear in various
non-infectious spinal diseases, such as degenerative changes, acute Schmorl’s node, spondyloarthropathy,
synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO), chronic recurrent
multifocal osteomyelitis, and calcium pyrophosphate dihydrate crystal deposition disease. The
imaging findings of infectious spondylitis that can be differentiated from these non-infectious
spinal diseases on MRI are high signal intensity and abscess of the disc space, an abscess in the
paraspinal soft tissue, and the loss of the linear low signal intensity on T1-weighted images of
the bony endplate. However, these differentiation points do not always apply since there are
many similarities in the imaging findings of infectious and non-infectious diseases. Therefore,
for an accurate diagnosis, it is important to know the imaging characteristics related to the
pathophysiology of not only infectious spondylitis but also non-infectious spinal diseases,
which requires differentiation from infection. |
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