MR signal abnormalities involving vertebral body endplates related to degenerative disc disease
Type I: Hypointense on T1WI, hyperintense on T2WI
Type II: Hyperintense on T1WI, isointense on T2WI
Type III: Hypointense on T1WI and T2WI
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Chen Y et al: Distribution of Modic changes in patients with low back pain and its related factors. Eur J Med Res. 24(1):34, 2019
Dudli S et al: Pathobiology of Modic changes. Eur Spine J. 25(11):3723-34, 2016
Albert HB et al: Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy. Eur Spine J. 22(4):697-707, 2013
Luoma K et al: Relationship of Modic type 1 change with disc degeneration: a prospective MRI study. Skeletal Radiol. 38(3):237-44, 2009
Thompson KJ et al: Modic changes on MR images as studied with provocative diskography: clinical relevance--a retrospective study of 2457 disks. Radiology. 250(3):849-55, 2009
Jensen TS et al: Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain. Eur Spine J. 17(11):1407-22, 2008
Rahme R et al: The modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine. AJNR Am J Neuroradiol. 29(5):838-42, 2008
Zhang YH et al: Modic changes: a systematic review of the literature. Eur Spine J. 17(10):1289-99, 2008
Modic MT et al: Lumbar degenerative disk disease. Radiology. 245(1):43-61, 2007
Senegas J: Mechanical supplementation by non-rigid fixation in degenerative intervertebral lumbar segments: the Wallis system. Eur Spine J. 11 Suppl 2: S164-9, 2002
Stumpe KD et al: FDG positron emission tomography for differentiation of degenerative and infectious endplate abnormalities in the lumbar spine detected on MR imaging. AJR Am J Roentgenol. 179(5): 1151-7, 2002
Weishaupt D et al: Painful lumbar disk derangement: relevance of endplate abnormalities at MR imaging. Radiology. 218(2):420-7, 2001
Sandhu HS et al: Association between findings of provocative discography and vertebral endplate signal changes as seen on MRI. J Spinal Disord. 13(5): 438-43, 2000
Van Goethem JW et al: The value of MRI in the diagnosis of postoperative spondylodiscitis. Neuroradiology. 42(8): 580-5, 2000
Braithwaite I et al: Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography. Eur Spine J. 7(5):363-8, 1998
Ito M et al: Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation. Spine. 23(11): 1252-8; discussion 1259-60, 1998
Ross JS et al: The postoperative lumbar spine: enhanced MR evaluation of the intervertebral disk. AJNR Am J Neuroradiol. 17(2): 323-31, 1996
Modic MT et al: Contrast-enhanced MR imaging in acute lumbar radiculopathy: a pilot study of the natural history. Radiology. 195(2): 429-35, 1995
Ulmer JL et al: Lumbar spondylolysis: reactive marrow changes seen in adjacent pedicles on MR images. AJR Am J Roentgenol. 164(2): 429-33, 1995
Ross JS et al: Current assessment of spinal degenerative disease with magnetic resonance imaging. Clin Orthop. (279): 68-81, 1992
Ross JS et al: Assessment of extradural degenerative disease with Gd-DTPA-enhanced MR imaging: correlation with surgical and pathologic findings. AJNR Am J Neuroradiol. 10(6):1243-9, 1989
Hueftle MG et al: Lumbar spine: postoperative MR imaging with Gd-DTPA. Radiology. 167(3):817-24, 1988
Masaryk TJ et al: High-resolution MR imaging of sequestered lumbar intervertebral disks. AJR Am J Roentgenol. 150(5):1155-62, 1988
Modic MT et al: Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology. 166(1 Pt 1):193-9, 1988
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
Vertebral endplate change, Modic changes
Type I, II, III endplate change
Definitions
MR signal abnormalities involving vertebral body endplates related to degenerative disc disease
Type I: Hypointense on T1WI, hyperintense on T2WI
Type II: Hyperintense on T1WI, isointense on T2WI
Type III: Hypointense on T1WI and T2WI
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Chen Y et al: Distribution of Modic changes in patients with low back pain and its related factors. Eur J Med Res. 24(1):34, 2019
Dudli S et al: Pathobiology of Modic changes. Eur Spine J. 25(11):3723-34, 2016
Albert HB et al: Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy. Eur Spine J. 22(4):697-707, 2013
Luoma K et al: Relationship of Modic type 1 change with disc degeneration: a prospective MRI study. Skeletal Radiol. 38(3):237-44, 2009
Thompson KJ et al: Modic changes on MR images as studied with provocative diskography: clinical relevance--a retrospective study of 2457 disks. Radiology. 250(3):849-55, 2009
Jensen TS et al: Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain. Eur Spine J. 17(11):1407-22, 2008
Rahme R et al: The modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine. AJNR Am J Neuroradiol. 29(5):838-42, 2008
Zhang YH et al: Modic changes: a systematic review of the literature. Eur Spine J. 17(10):1289-99, 2008
Modic MT et al: Lumbar degenerative disk disease. Radiology. 245(1):43-61, 2007
Senegas J: Mechanical supplementation by non-rigid fixation in degenerative intervertebral lumbar segments: the Wallis system. Eur Spine J. 11 Suppl 2: S164-9, 2002
Stumpe KD et al: FDG positron emission tomography for differentiation of degenerative and infectious endplate abnormalities in the lumbar spine detected on MR imaging. AJR Am J Roentgenol. 179(5): 1151-7, 2002
Weishaupt D et al: Painful lumbar disk derangement: relevance of endplate abnormalities at MR imaging. Radiology. 218(2):420-7, 2001
Sandhu HS et al: Association between findings of provocative discography and vertebral endplate signal changes as seen on MRI. J Spinal Disord. 13(5): 438-43, 2000
Van Goethem JW et al: The value of MRI in the diagnosis of postoperative spondylodiscitis. Neuroradiology. 42(8): 580-5, 2000
Braithwaite I et al: Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography. Eur Spine J. 7(5):363-8, 1998
Ito M et al: Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation. Spine. 23(11): 1252-8; discussion 1259-60, 1998
Ross JS et al: The postoperative lumbar spine: enhanced MR evaluation of the intervertebral disk. AJNR Am J Neuroradiol. 17(2): 323-31, 1996
Modic MT et al: Contrast-enhanced MR imaging in acute lumbar radiculopathy: a pilot study of the natural history. Radiology. 195(2): 429-35, 1995
Ulmer JL et al: Lumbar spondylolysis: reactive marrow changes seen in adjacent pedicles on MR images. AJR Am J Roentgenol. 164(2): 429-33, 1995
Ross JS et al: Current assessment of spinal degenerative disease with magnetic resonance imaging. Clin Orthop. (279): 68-81, 1992
Ross JS et al: Assessment of extradural degenerative disease with Gd-DTPA-enhanced MR imaging: correlation with surgical and pathologic findings. AJNR Am J Neuroradiol. 10(6):1243-9, 1989
Hueftle MG et al: Lumbar spine: postoperative MR imaging with Gd-DTPA. Radiology. 167(3):817-24, 1988
Masaryk TJ et al: High-resolution MR imaging of sequestered lumbar intervertebral disks. AJR Am J Roentgenol. 150(5):1155-62, 1988
Modic MT et al: Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology. 166(1 Pt 1):193-9, 1988
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