Utility of the claw sign in spine magnetic nuclear resonance with diffusion to differentiate Modic type I changes for degenerative disease versus infection

Montoya, Juan Esteban Muñoz; Cataño, Carlos Pérez; Cuellar, Angela María Tapicha; Osorio, María Paula Vargas; Cano, Jimar Rivero; Suárez, Juan Carlos Luque; Lopez, Marco Luciano Charry

doi:10.21037/jss.2018.07.06

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…The claw sign is very predictive of degeneration and has a high negative predictive value against infection. Conversely, diffuse or amorphous diffusion-weighted imaging (DWI) hyperintensity, without a claw morphology, predicts infectious spondylodiscitis (31).…”

Section: Differential Diagnosismentioning

confidence: 99%

Adult Pyogenic Spinal Infections

Akyol¹

2023

Erciyes Med J

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Pyogenic spinal infections are potentially life-threatening diseases that can impair the patient's neurological status, physical abilities, and quality of life. They can be considered a single disease or group of diseases and include spondylitis, discitis, facet arthritis, epidural phlegmon/abscesses, peri/paraspinal soft tissue infection/abscesses, pachymeningitis and/or leptomeningitis, and myelitis/spinal cord abscess. This group of diseases is distinct from degenerative diseases, metabolic and inflammatory disorders, and neoplasms and mimickers. Delays in the diagnosis and treatment can cause significant morbidity and mortality. Imaging is important in preparing diagnoses, planning minimally invasive treatment, and monitoring patient progress. This review explains the adult spinal infections' radiological imaging features and their values in differential diagnoses.

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Section: Differential Diagnosismentioning

confidence: 99%

Adult Pyogenic Spinal Infections

Akyol¹

2023

Erciyes Med J

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“…Unfortunately, DDD patients with MC were not differentiated from DDD patients without MC in clinical trials on intradiscal MSC injections in DDD patients. In fact, patients with MC were occasionally excluded from the clinical trials, thereby possibly omitting a group of potential responders to MSC injections [ 73 , 75 , 135 ]. Therefore, the efficacy of discal MSC treatments against MC1 has yet to be investigated in future clinical trials.…”

Section: Patient Stratification: Msc Therapy For Ddd Patients With Mc1mentioning

confidence: 99%

“…The immunomodulatory cytokines TSG-6, IL-10, and TGF-β secreted by MSCs counteract the pro-inflammatory effects of TNF-α and IL-1β in IVDs. TNF-α and IL-1β are key inflammatory mediators found in DD [ 59 ] and are frequently used in in vitro experiments to investigate the effect of discal inflammation on IVDCs [ 133 , 134 , 135 ]. IL-1β stimulation of IVDCs induces the downregulation of stemness-associated genes and upregulates pro-inflammatory, pro-angiogenic, and catabolic genes [ 141 , 143 , 144 ].…”

Section: Possible Mode Of Action Of Mscs In Mc1mentioning

confidence: 99%

“…Treating IL-1β-stimulated NPCs with TSG-6 reduced IL-6 and TNF-α secretion, increased the proliferation rate of NPCs, and promoted ECM synthesis [ 133 ]. IL-10 was found to increase the expression of ECM-associated genes and decrease the expression of inflammatory genes in IL-1β-stimulated NPCs [ 135 ]. TGF-β stimulation of degenerative AF cells grown in micromass culture increased the ECM production [ 145 ].…”

Section: Possible Mode Of Action Of Mscs In Mc1mentioning

confidence: 99%

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Should Degenerated Intervertebral Discs of Patients with Modic Type 1 Changes Be Treated with Mesenchymal Stem Cells?

Herger

Bermudez-Lekerika

Farshad

et al. 2022

IJMS

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Low back pain (LBP) has been among the leading causes of disability for the past 30 years. This highlights the need for improvement in LBP management. Many clinical trials focus on developing treatments against degenerative disc disease (DDD). The multifactorial etiology of DDD and associated risk factors lead to a heterogeneous patient population. It comes as no surprise that the outcomes of clinical trials on intradiscal mesenchymal stem cell (MSC) injections for patients with DDD are inconsistent. Intradiscal MSC injections have demonstrated substantial pain relief and significant disability-related improvements, yet they have failed to regenerate the intervertebral disc (IVD). Increasing evidence suggests that the positive outcomes in clinical trials might be attributed to the immunomodulatory potential of MSCs rather than to their regenerative properties. Therefore, patient stratification for inflammatory DDD phenotypes may (i) better serve the mechanisms of action of MSCs and (ii) increase the treatment effect. Modic type 1 changes—pathologic inflammatory, fibrotic changes in the vertebral bone marrow—are frequently observed adjacent to degenerated IVDs in chronic LBP patients and represent a clinically distinct subpopulation of patients with DDD. This review discusses whether degenerated IVDs of patients with Modic type 1 changes should be treated with an intradiscal MSC injection.

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DWI of the Spine: A Review and Update

Shalaby,

Chaker,

Moawad

et al. 2024

neurograph

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The utility of DWI in the spine has been established and continues to grow in clinical practice. DWI raises the MR imaging sensitivity of lesion detection and improves the conspicuity of many spinal pathologies. Applications include evaluation of spinal cord infarction, bone marrow lesions, infection, degenerative disease, trauma, osteoporosis, malignancy, and response to therapy. In this article, we provide a case-based review to illustrate and discuss these uses. We also highlight DWI acquisition techniques and challenges. We provide protocol optimization tips that help to overcome these challenges and permit incorporation of DWI into the workflow.Learning Objective: To emphasize the role of DWI in the spine and discuss technical tips and considerations for protocol optimization

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Utility of the claw sign in spine magnetic nuclear resonance with diffusion to differentiate Modic type I changes for degenerative disease versus infection

Cited by 4 publications

References 20 publications

Adult Pyogenic Spinal Infections

Adult Pyogenic Spinal Infections

Should Degenerated Intervertebral Discs of Patients with Modic Type 1 Changes Be Treated with Mesenchymal Stem Cells?

DWI of the Spine: A Review and Update

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