Magnetic resonance imaging of acute intraosseous disc herniation

Clin Radiol. 1998 May;53(5):363-8. doi: 10.1016/s0009-9260(98)80010-x.

Abstract

Schmorl's nodes, the result of previous intraosseous disc herniation (IODH), are a common incidental finding on plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI). Acute IODH can, however, cause severe back pain, and the radiological features may also lead to inappropriate suspicion of malignancy or infection. We present eight cases of acute IODH in order to illustrate how the correct diagnosis can be made by MRI. In six cases isotope bone scintigraphy had been performed, demonstrating focal increased activity at the site of IODH. MRI can reinforce the concern about serious underlying pathology by the demonstration of marrow oedema, which may be localized around the disc herniation or extensive, extending throughout the vertebral body and into the pedicles. The key to the correct diagnosis is the recognition of the endplate defect and disc herniation. In three cases the diagnosis may have been possible from plain radiographs in which disc calcification visible on previous radiographs had migrated into an intraosseous location.

MeSH terms

  • Acute Disease
  • Adolescent
  • Back Pain / etiology
  • Bone Marrow Diseases / diagnosis
  • Edema / diagnosis
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Displacement / complications
  • Intervertebral Disc Displacement / diagnosis*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Retrospective Studies