Spine MRI

📌 For a patient with an acute compression fracture, why is the disc hyperintense on T2WI?

MSK MRI 2025. 2. 19. 22:41

https://youtu.be/gmZnFD2KfmE


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✅Possible Causes of T2 Hyperintensity in the L1-2 Disc:

  1. Reactive Edema & Inflammation – Increased water content due to endplate trauma.
  2. Mechanical Stress & Microtears – Micro-injuries within the disc leading to fluid accumulation.
  3. Endplate Damage & Nutrient Disruption – Impaired disc nutrition alters hydration.
  4. Hematoma Formation (Acute Stage) – Possible hemorrhagic component in the disc.
  5. Adjacent Bone Marrow Edema Effect – Inflammatory diffusion from the fractured vertebra.

 

✅Key Differentiation Points:

  • Traumatic vs. Degenerative: Unlike degenerative changes, traumatic disc edema is focal, acute, and adjacent to the fracture.
  • Infectious vs. Traumatic: No significant enhancement or disc space narrowing suggests trauma over infection.
  • Neoplastic vs. Traumatic: No mass effect, preserved disc morphology, and isolated findings favor trauma over neoplasm.

 

#vertebralFracture, #discEdema, #spinalTrauma, #MRIfindings, #T2hyperintensity, #acuteCompression, #endplateInjury, #discPathology, #traumaticChanges, #spinalImaging

 

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