Imaging Findings in Spinal Neuroarthropathy

Can Imaging Findings Help Differentiate Spinal Neuropathic Arthropathy from Disk Space Infection? Initial Experience

“…Our MR imaging findings were similar to those of Kapila and Lines (16) and Arnold et al (20), who reported decreased signal intensity in the disk and adjacent vertebral bodies on T1-weighted images and increased signal intensity on T2-weighted images. Our findings, however, differed from those of Park et al (17), who reported decreased signal intensity on T2-weighted images. c.…”

“…Debris and disorganization also were seen more commonly on radiographs, CT scans, and MR images in patients with spinal neuropathic arthropathy than in those with disk space infection. These findings were similar to those in previous reports (16,17), but our findings also included endplate erosion, vertebral body spondylolisthesis (anteroor retrospondylolisthesis), vacuum disk, and facet involvement.…”

“…Endplate erosion, endplate sclerosis, osteophyte formation, loss of disk height, paraspinal soft-tissue mass, and signal intensity characteristics on T1-and T2-weighted MR images were not useful for the differentiation of spinal neuropathic arthropathy from disk space infection. The reported (16,17) observation that T2-weighted MR images can help differentiate spinal neuropathic arthropathy from disk space infection was not supported by our results. To further evaluate the MR imaging findings in patients with spinal neuropathic arthropathy, it may be useful to compare such findings over time to determine if the characteristics on T2-weighted images correlate with stage of disease.…”

“…Previous observers (3,5,15,16) have reported that conventional radiographic and CT findings of spinal neuropathic arthropathy mimic findings of discitis and osteomyelitis. It has been suggested (3,5,(15)(16)(17), however, that MR imaging may help differentiate neuropathic changes from infection. To our knowledge, the present work included the largest series of imaging studies in patients with spinal neuropathic arthropathy, which were used to determine if imaging findings can help differentiate spinal neuropathic arthropathy from disk space infection.…”

Magnetic resonance imaging appearances of different discovertebral lesions

“…Findings in favor of renal destructive spondyloarthropathy include the combination of pronounced discovertebral destruction with absence of significant high signal intensity within the erosions and the neighboring bone marrow on T2W SE images. However, lack of hyperintensity on T2W SE images has been also reported in spinal neuroarthropathy and fungal spinal osteomyelitis [35,36].…”