Diagnostic of degenerative disc disease

What is it?

MRI allows to study not only the disc-radicular complex, but the whole osteo-articular apparatus of the spine, as well as the paravertebral soft tissues, in search of possible degenerative-inflammatory processes. Through this examination, it is possible to evaluate the degree of disc degeneration/mechanical instability (Modic's sign) as different signals at the level of the plates and vertebral bodies and of "disc wear" (Pfirmann's classification). CT is very useful for the evaluation of the osteoarticular complex, thus necessary for the study of facet joints and marginal or endocanal osteophytes.

When is this exam indicated?

Radiographic (X-ray) examination should be performed following the onset of low back pain unresponsive to conservative therapy for a period longer than 6 weeks, primarily in the presence of indicators of major pathology (fracture, tumor, or infection), especially in subjects younger than 20 years or older than 55 years or in the presence of a clinically evident deformity. The radiographic examination should be performed in two projections (AP and lateral) under load. Functional or dynamic radiographic examination may be indicated in cases of suspected vertebral instability (isthmic or degenerative spondylolisthesis, etc.).

How is it performed?

The teleradiography of the rachis (TeleRX) in orthostasis with standard technique is carried out with X-rays obtaining an image of the skeleton defined in 2 projections. Low-dose-radiation spinal teleradiography (EOS) allows to perform the same examination but with a much lower quantity of radiation and with the possibility to perform three-dimensional reconstructions of the column or of the whole skeleton.


Teleradiography of the spine (TeleRX) or EOS and CT are contraindicated for pregnant women. The major contraindications for MRI are: MRI non-compatible metals, metal splinters, dental prosthesis, state of pregnancy, pace-makers, intrauterine devices (IUD). In case of use of contrast medium (both iodine for CT and gadolinium for MRI), which happens quite rarely, the patient must follow an appropriate anti-allergic preparation.

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