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The obtained information on bone marrow changes is of important value in diagnostic work-up and response assessment.
Please note that type 2 degenerative bone marrow changes at L5 S1 and L3 L4 do not demonstrate the claw sign.
Fluid in the disc is highly associated with the presence of the vacuum phenomenon, type 1 bone marrow changes (Modic 1) and severe end plate abnormalities.
Some of the bone marrow changes identified on MRI are of course incidental findings and resolve spontaneously and never have associated clinical symptoms.
Oedema-like bone marrow changes therefore represent a tissue reaction to a variety of stimuli; trabecular microfractures leading to bone repair is one of them.
MR findings are non-specific, but extensive bone marrow changes and/or a "budding appearance" of bone lesions may be suggestive of the diagnosis.
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Bone marrow change is of course difficult to assess with CT.
Computer tomography (CT) is more sensitive than radiography but cannot reliably show bone marrow change [36, 37].
The combination of a fat-suppressed fluid-sensitive sequence and a T1w sequence also allows to identify fatty (low signal in fat sat, high in T1w) and sclerotic (low signal in all sequences) bone marrow change.
Logistic regression was used to assess repeat bone marrow biopsies, changes in chemotherapy, and diagnostic uncertainty (stability and change in diagnosis).
Open image in new window Fig. 17 Degenerative bone marrow (Modic) changes.
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