Are Modic changes 'Primary infective endplatitis'?-insights from multimodal imaging of non-specific low back pain patients and development of a radiological 'Endplate infection probability score'.

Dr Shanmuganathan Rajasekaran Pushpa Bhari Thippesamy Dilip Chand Raja S Karuppanan Sukumaran Sri Vijay Anand Chandhan Murugan Meena Nedunchelian Rishi Mugesh Kanna Ajoy Prasad Shetty Chitraa Tangavel Raveendran Muthurajan

Published in: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2022)

Multimodal imaging showed many radiological signs not easily seen in MRI alone and thus missed in Modic classification. There were distinct radiological differences between EPCs of trauma and infection which allowed the development of an EIPS. The scores showed that 67.64% of our study patients with Modic changes had EPCs resembling infection rather than trauma suggesting the possibility of an infective aetiology and allowing us to propose an alternate theory of 'Primary Endplatitis'.

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