Vertebral Body, T1 Hypointense Signal, Focal
Bryson Borg, MD
DIFFERENTIAL DIAGNOSIS
Common
Basivertebral Vein
Schmorl Node
Bone Island
Hemangioma (Atypical)
Fracture
Surgical Material
Metallic Hardware
Bone Cement
Osteomyelitis, Pyogenic
Osteomyelitis, Granulomatous
Degenerative Endplate Change (Types 1 & 3)
Metastases
Multiple Myeloma
Less Common
Limbus Vertebra
Kümmell Disease
Rare but Important
Vertebral Pneumatocyst
ESSENTIAL INFORMATION
Helpful Clues for Diagnoses
Basivertebral Vein
Linear or triangular structure projecting ventrally from the center of the posterior body
Schmorl Node
Hypointense T1, variably hyperintense T2, circumscribed vertebral body lesion
In continuity with an adjacent disc space
Bone Island
Focal sclerotic lesion, markedly hypointense on all sequences, with normal marrow signal elsewhere
CT may be useful to confirm diagnosis
Hemangioma (Atypical)
Some lipid-poor hemangiomas are isointense or hypointense to marrow on T1WI
Bone algorithm CT can assess for characteristic bony features (thickened vertical trabeculae)
Fracture
Fracture line often difficult to delineate on MR
Associated marrow edema hypointense on T1WI
Osteomyelitis, Pyogenic
Hypointense T1 marrow signal adjacent to the level of infection
Metastases
Nearly all metastases hypointense on T1WI, whether blastic or lytic
Multiple lesions typical
Limbus Vertebra
Unfused fragment of the ring apophysis, usually anterosuperior vertebral margin
Mid-lumbar most common
Kümmell Disease
Post-traumatic osteonecrosis
Horizontal, gas-filled intravertebral cleft is a characteristic finding; appears as signal void on MRRelated posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
