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IMAGING OF DEGENERATIVE CHANGES
Degenerative change in the intervertebral disc is
best visualized in its early stages on MRI scan. T2
weighted MR images of the lumbar spine measure
the hydration status of the disc, which gradually
decreases in the presence of degenerative changes.
This results in a change in the signal intensity within
the disc, which is easily seen. Radial and
circumferential tears can also be visualized on MR
images. On CT scan imaging, gas formation can be
seen within the radial tears and the annulus during
the reabsorption phase
immaging of degenerative changes 1
As degenerative changes progress, narrowing of the disc
space from disc reabsorption can be noted
on standard X-rays, as can the growth of circumferential
osteophytes. Sclerotic changes within the facet to joints
can also be noted on standard X-rays .Better visualization
of these changes is achieved by means of CT scan or MR
images, which can document the growth of osteophytic
spurs and determine whether they encroach on the spinal
canal or neuroforamina
immaging of degenerative changes 2
Axial (a) and sagittal (b)
computed tomography images
of degenerative lumbar
spondylosis.
The intervertebral disc has
lost height, and there is gas in
the disc space which appears
black on CT images (arrow).
On the axial image, there is
lateral protrusion of the disc
margin to the left
immaging of degenerative changes 3
Anteroposterior view of
the lumbar spine
demonstrating increased
radiodensity in the right
L5–S1 posterior facet
(apophyseal) joint (a). On
the axial T2 magnetic
resonance image, there is
increased signal intensity
in the right posterior
(apophyseal) joint,
consistent with increased
synovial fluid(arrow)
immaging of degenerative changes 4
Lateral radiograph of lumbar spine
demonstrating increased
radiodensity across the endplates of
the L4–L5 and L5–S1
vertebrae. The Knutt son gas
phenomenon is present at L4–L5
(arrow), indicative of advanced
degeneration of the L4–L5 disc.
There are traction spurs anteriorly
at L4–L5 (arrows) and
L5–S1, which occur with
segmental instability
immaging of degenerative changes 5
This light microscopic cross-
sectional view through the facet
joint shows very early degenerative
changes in the posterior joint. The
purple-staining articular cartilage
represents normal cartilage. The
arrow points to a thin sausage-
shaped tag of synovial tissue lying
between the articular surfaces.
immaging of degenerative changes 6
Light microscopic
cross-section of the
posterior facet joint.
The arrow points to
thin degenerate
cartilage on the upper
part of the
joint. A large thick
fibrofatty tag extends
from the joint capsule
on the right, lying
between the two
purple articular
surfaces
immaging of degenerative changes 7
Longitudinal sagittal section
through the lumbar spine at
the L4–L5 level showing
advanced degeneration of the
intervertebral disc and the
posterior facets. The
intervertebral foramen (large
arrow) is much reduced in
size as the result of
impingement by an
enlarged superior articular
process of the facet of L5
(small arrow).
immaging of degenerative changes 8
Longitudinal sagittal view of
the lumbar spine at the L4–L5
level showing marked
degenerative changes in the
posterior facet joint
and the intervertebral disc.
There is entrapment of the
synovium within the joint
(left arrow). The breakdown
in the disc is evident
(right arrow) with bulging
posteriorly. The spinal canal
is narrowed due to the
combined effects of the joint
hypertrophy and the
bulging disc.
immaging of degenerative changes 9

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imaging of spinal degeneration

  • 1. IMAGING OF DEGENERATIVE CHANGES Degenerative change in the intervertebral disc is best visualized in its early stages on MRI scan. T2 weighted MR images of the lumbar spine measure the hydration status of the disc, which gradually decreases in the presence of degenerative changes. This results in a change in the signal intensity within the disc, which is easily seen. Radial and circumferential tears can also be visualized on MR images. On CT scan imaging, gas formation can be seen within the radial tears and the annulus during the reabsorption phase immaging of degenerative changes 1
  • 2. As degenerative changes progress, narrowing of the disc space from disc reabsorption can be noted on standard X-rays, as can the growth of circumferential osteophytes. Sclerotic changes within the facet to joints can also be noted on standard X-rays .Better visualization of these changes is achieved by means of CT scan or MR images, which can document the growth of osteophytic spurs and determine whether they encroach on the spinal canal or neuroforamina immaging of degenerative changes 2
  • 3. Axial (a) and sagittal (b) computed tomography images of degenerative lumbar spondylosis. The intervertebral disc has lost height, and there is gas in the disc space which appears black on CT images (arrow). On the axial image, there is lateral protrusion of the disc margin to the left immaging of degenerative changes 3
  • 4. Anteroposterior view of the lumbar spine demonstrating increased radiodensity in the right L5–S1 posterior facet (apophyseal) joint (a). On the axial T2 magnetic resonance image, there is increased signal intensity in the right posterior (apophyseal) joint, consistent with increased synovial fluid(arrow) immaging of degenerative changes 4
  • 5. Lateral radiograph of lumbar spine demonstrating increased radiodensity across the endplates of the L4–L5 and L5–S1 vertebrae. The Knutt son gas phenomenon is present at L4–L5 (arrow), indicative of advanced degeneration of the L4–L5 disc. There are traction spurs anteriorly at L4–L5 (arrows) and L5–S1, which occur with segmental instability immaging of degenerative changes 5
  • 6. This light microscopic cross- sectional view through the facet joint shows very early degenerative changes in the posterior joint. The purple-staining articular cartilage represents normal cartilage. The arrow points to a thin sausage- shaped tag of synovial tissue lying between the articular surfaces. immaging of degenerative changes 6
  • 7. Light microscopic cross-section of the posterior facet joint. The arrow points to thin degenerate cartilage on the upper part of the joint. A large thick fibrofatty tag extends from the joint capsule on the right, lying between the two purple articular surfaces immaging of degenerative changes 7
  • 8. Longitudinal sagittal section through the lumbar spine at the L4–L5 level showing advanced degeneration of the intervertebral disc and the posterior facets. The intervertebral foramen (large arrow) is much reduced in size as the result of impingement by an enlarged superior articular process of the facet of L5 (small arrow). immaging of degenerative changes 8
  • 9. Longitudinal sagittal view of the lumbar spine at the L4–L5 level showing marked degenerative changes in the posterior facet joint and the intervertebral disc. There is entrapment of the synovium within the joint (left arrow). The breakdown in the disc is evident (right arrow) with bulging posteriorly. The spinal canal is narrowed due to the combined effects of the joint hypertrophy and the bulging disc. immaging of degenerative changes 9