Diffuse vertebral body edema due to calcified intraspongious disk herniation

Abstract

We describe the case of a patient with a recent history of high back pain, with magnetic resonance imaging (MRI) of the thoracic spine showing intervertebral disk herniation into the spongious bone of the vertebral body of T9 that might have caused diffuse, low signal intensity on fluid-attenuated inversion recovery T1-weighted (FLAIR-T1W) images, high signal intensity magnetic resonance (MR) on T2-weighted (T2W) images and T2-weighted fat-suppressed images (T2W-FSIs) and marked enhancement on the vertebral body of T9 with gadolinium on T1-weighted fat-suppressed images (T1W-FSIs) images. Those findings suggested diffuse edema and might be indistinguishable from tumoral or inflammatory diseases, but the plain films and the reformatted sagittal computed tomography scans of the thoracic spine were helpful to show a calcified part of the intervertebral disk migrating into the vertebral body of T9. The patient made full recovery from the symptoms after conservative treatment and at the follow-up MRI showed normalization of the bone marrow signal intensity of the vertebral body of T9.

Acute symptomatic calcific discitis in adults: a case report and review of literature

“…Computed tomography and discal calcification will allow one to distinguish CD from Smith [4] a bone tumour such as an osteoid osteoma or an osteoblastoma. Contrast enhancement of the vertebral body may be seen if the CD herniates into the vertebral body due to the inflammatory response secondary to CD [2,6]. In cases of spondylodiscitis, contrast enhancement would be expected in the intervertebral disc with or without a paravertebral abscess.…”

“…These are generally asymptomatic and associated with an underlying predisposing systemic condition such as hyperparathyroidism, chondrocalcinosis and haemochromatosis [3]. Idiopathic symptomatic CD in adults is extremely rare and currently, only eight cases have been reported [2,[4][5][6][7][8][9]. We present a case of acute idiopathic symptomatic CD occurring in the thoracic spine, review the relevant literature and discuss the radiological features.…”

Magnetic Resonance Imaging Characterization of Vertebral Endplate Changes in the Dog

“…Radiography is an insensitive means for their diagnosis, with a reported 5–35% detection rate. Presence of bony reaction surrounding these nodes on MR images has been interpreted as evidence of primary endplate weakening due to infection, metabolic, neoplastic or traumatic events, although most Schmorl's lesions do not have bone reaction , …”

Acute Symptomatic Calcific Discitis Mimicking a Septic Spondylodiscitis

“…is finding might be mistakenly attributed to an infectious lesion. To avoid this confusion, a CT scan should be performed to detect the calcification within the disc [1,5].…”

“…Incident disc calcification is reported in 5% of chest radiographs and 6% of abdominal plain films, as well as in 70% of postmortem adult examinations [2]. However, these calcifications generally remain asymptomatic, but when they do manifest, they can induce acute onset severe spinal pain and stiffness, with imaging features mimicking infectious spondylodiscitis [1][2][3][4][5][6][7][8]. On the other hand, pyogenic spondylodiscitis can be extremely severe and is associated with high mortality rates ranging from 2 to 20% in the literature, which makes it a potentially life-threatening disease [9].…”