MR images obtained 6 days after injury of a 38-year-old man who experienced the sudden onset of pain and point tenderness referable to the L2 level immediately.

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Presentation transcript:

MR images obtained 6 days after injury of a 38-year-old man who experienced the sudden onset of pain and point tenderness referable to the L2 level immediately after experiencing axial-loading injury. MR images obtained 6 days after injury of a 38-year-old man who experienced the sudden onset of pain and point tenderness referable to the L2 level immediately after experiencing axial-loading injury. A, T1-weighted sagittal (600/15/2) image shows subtle concave compression of the caudal L2 endplate without obvious disk extension but with localized marrow edema. The margin of the SN is not well delineated because of the marrow edema, but a very small cortical defect representing an endplate fracture is present (arrow).B, After the administration of contrast material, enhancement of the marrow edema peripheral to and within the SN defect can be seen. The margins of the SN are slightly more visible after the injection of the contrast material (arrows).C, Gradient-echo (400/15/1) image best shows endplate invagination of disk material, establishing this abnormality as an acute SN. The margin of the SN can be most clearly appreciated as a linear area of decreased signal surrounding the extruded disk material (arrows) on the gradient-echo image. At 4-month follow-up, when the patient's pain had resolved, the edema had disappeared but the appearance of the SN on T2-weighted images was otherwise unchanged. Andrew L. Wagner et al. AJNR Am J Neuroradiol 2000;21:276-281 ©2000 by American Society of Neuroradiology