Imaging of Musculoskeletal Disorders Degenerative disc disease
Key features
Disc space narrowing
Disc bulging
Osteophytes
Endplate irregularity and sclerosis
Degeneration of the intervertebral discs of the spine is a very common phenomenon in adults which may or may not be symptomatic. The lumbar and cervical spine are most commonly affected.
X-rays commonly show vertebral body osteophytes. The vertebral body endplate surfaces may become sclerotic (whiter than normal), thickened and irregular. Narrowing of the disc spaces is due to reduced height of the intervertebral discs; the discs themselves are not visible with X-ray.
The disc spaces are narrow due to reduction of disc height
Prominent vertebral body osteophytes have formed anteriorly
Cortical irregularity of the facet joints is a sign of facet joint arthrosis
Note: The intervertebral disc spaces are not synovial joints and so osteoarthritis is an incorrect term for degenerative disc disease. However, the facet joints are synovial joints and so are susceptible to osteoarthritis – often referred to as ‘arthrosis’.
(Same patient as MRI below)
In patients who have nerve root symptoms in the arms or legs, MRI can be helpful to determine the location of disc disease and the location of nerve root impingement.
Note: Imaging of the lumber spine is not indicated routinely even if there is sciatica – MRI is generally reserved for patients who have not responded to conservative management
