Modic changes and spondylodiscitis at multiple levels of the thoracolumbar spine in a patient with ankylosing spondylitis.

Abstract

Modic changes (MC) on magnetic resonance imaging (MRI) were described in 1988 by Modic et al. in a study among patients with chronic low back pain. Type 1 changes were shown to represent an acute inflammatory process while type 2 changes were found in chronic lesions. Since mechanical back pain is very common, it is often difficult to differentiate precisely the origin of the back pain in patients with ankylosing spondylitis (AS) based only on clinical assessment, laboratory findings and/or plain imaging. We report a male patient with AS who presented with low back pain. MRI revealed MCs and spondylodiscitis, an uncommon manifestation of AS, at multiple levels of the thoracolumbar spine. We believe that MRI may provide key information in addition to the clinical, laboratory and plain radiological assessments and can help to guide physicians in decision-making when treating patients with AS.