Radiologic Mimics of Osteomyelitis and Septic Arthritis: A Pictorial Essay

Figure 7

End plate degeneration. Sagittal T2 (a), T1 (b), and STIR (c) lumbar spine of a 40-year-old female presenting with right L5 radiculopathy in the background of low back pain. The fluid-hyperintensity (a, c) and T1 hypointense marrow signal (b) on either side of the L4/5 end plate (arrow), in the context of end plate irregularity and preservation of normal/hypointense disc signal, is consistent with inflammatory or Modic type I degeneration. The radiculopathy was secondary to impingement of the right L5 nerve root from the herniated disc at this level (not shown). Sagittal CT lumbar spine of a different patient (d) shows a vacuum cleft in the L5/S1 disc space with adjacent end plate sclerosis (Modic III degeneration). The vacuum cleft is a useful sign of degeneration.

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