Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review

Abstract

Magnetic resonance (MR) imaging plays an important role in the evaluation of bacterial and tuberculous spondylodiscitis and associated complications. Owing to its high sensitivity and specificity, it is a powerful diagnostic tool in the early diagnosis of ongoing infections, and thus provides help in prompt initiation of appropriate, therapy which may be medical or surgical, by defining the extent of involvement and detection of complications such as epidural and paraspinal abscesses. More specifically, MR imaging helps in differentiating bacterial from tuberculous infections and enables follow up of progression or resolution after appropriate treatment. However, other non-infectious pathology can demonstrate similar MR imaging appearances and one should be aware of these potential mimickers when interpreting MR images. Radiologists and other clinicians need to be aware of these potential mimics, which include such pathologies as Modic type I degenerative changes, trauma, metastatic disease and amyloidosis. In this pictorial review, we will describe and illustrate imaging findings of bacterial and tuberculous spondylodiscitis, their complications and non-infectious pathologies that mimic these spinal infections.

Vertebral Bone Marrow and Endplate Assessment on MR Imaging for the Differentiation of Modic Type 1 Endplate Changes and Infectious Spondylodiscitis

“…Vertebral endplate destruction is typical for spondylodiscitis [21][22][23][24][25][27][28][29][30]. However, in this study, endplates in MT1, and early and advanced spondylodiscitis were found to be normal in up to 10.2%, 18.2%, and 5.7%, respectively.…”

Primary cervical spine AL‐κ amyloidoma: A case report and review of the literature

“…Reports of spine amyloidomas are rare: 20 cervical, 20 thoracic, five lumbar, one cervicothoracic, and one thoracolumbar have been published. Cases of cervical amyloidoma are presented in Table .…”

“…Reports of spine amyloidomas are rare: 20 cervical, 12-31 20 thoracic, [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] five lumbar, 52-54 one cervicothoracic, 55 and one thoracolumbar 56 have been published. Cases of cervical amyloidoma are presented in Table 1.…”

Quantitative MRI in early intervertebral disc degeneration: T1rho correlates better than T2 and ADC with biomechanics, histology and matrix content

“…Furthermore, it is difficult to determine whether water loss is due to daily activity and circadian (diurnal) rhythm (which is known to influence both water and height parameters) [ 22 ], or a water content drop in the ECM due to a loss of proteoglycans (PG’s) from the matrix and therewith the inability to retain water [ 23 – 25 ]. Finding matrix degeneration on T2w-images can also be obscured or mimicked by influx of fluids during an infectious or inflammatory process [ 26 ] or by the presence of free water in the lacunas of degraded ECM [ 27 ]. In addition, T2w- and PD-imaging are not informative of the discs’ mechanical (dys)function, or the cause of degeneration and pain [ 28 – 32 ].…”