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Old 12-03-2005, 04:08 PM   #1
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AliRah HB User
Modic Changes

Hi Everyone,

I have had back pain for almost 6 years now. Mostly controlled with NASID and steroids for flare-ups.

The pain has been constant for the past 9 months with mostly bad days.

I had an MRI of SI Joints and lumbar spine and will not be able to see my RA doctor for another 2 months. I like to know what the following means.

“Modic changes within the anterior, superior and inferior aspects of lower thoracic and lumbar vertebral bodies”

“There is also an anterior paraspinal ossfication at L3-L4 with preservation of disc space and normal intensity within L3-L4”.

“There is no evidence of synovitis or any inflammatory type arthritis”

I really like to know about the Modic changes.

Regards,

Ali

 
Old 12-03-2005, 05:54 PM   #2
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Location: New York
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proboy74 HB User
Re: Modic Changes

hi there....found some info for you...hope this helps: Modic changes, a common observation in MR imaging, are signal intensity changes in vertebral body marrow adjacent to the endplates of degenerative discs.

Michael T. Modic, MD, professor of radiology and neurology at Case Western in Cleveland, wrote about these changes in the journal Radiology in 1988, and his name has been associated with these changes ever since.

Modic changes take 3 main forms:

Type I

Decreased signal on T1, and increased signal on T2.

Represents marrow edema.

Associated with an acute process.

Histological examination shows disruption and fissuring of the endplate and vascularized fibrous tissues within the adjacent marrow

Type II - the most common type

Increased signal on T1, and isointense or slightly hyperintense signal on T2.

Represents fatty degeneration of subchondral marrow.

Associated with a chronic process.

Histological examination shows endplate disruption with yellow marrow replacement in the adjacent vertebral body.

Type I changes convert to Type II changes with time, while Type II changes seem to remain stable.

Type III

Decreased signal on both T1 and T2.

Correlate with extensive bony sclerosis on plain radiographs.

Histological examination shows dense woven bone; hence, no marrow to produce MRI signal.



MODIC CHANGES on MRI


T1 T2 significance



TYPE 1
¯
*
edema

TYPE II *
®

(or slight *)
fatty degeneration

TYPE III ¯
¯
bony sclerosis
__________________
10/26/05-Anterior/Posterior Lumbar Interbody Fusion L4-S1

 
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