Fact-sheet: Intravertebral disc herniation
Updated on 07/22/2024 at 11:06 AM
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Definition
Protrusion of the intervertebral disc through the adjacent vertebral endplate(s), which may be associated with edema.
Clinical features
Intravertebral disc herniations are very common and most often asymptomatic
Pain in cases of acute intravertebral disc herniation with edematous reaction
Radiography
Radiolucent lesion sometimes with peripheral sclerosis, most often involving the inferior endplate of one or more vertebral bodies of the lower thoracic spine and lumbar spine.
May involve the superior endplate
More rarely, involves both endplates adjacent to the disc
CT
More sensitive than radiography.
Possible intraherniary migration of discal gas
Intravertebral disc herniation is one of the Sorenson criteria for the diagnosis of Scheuermann disease
MRI
In cases of intraherniary migration of discal gas: central signal void.
In cases of acute or symptomatic intravertebral disc herniation:
- peripheral bone marrow edema
- peripheral enhancement (if contrast is administered)
Differential diagnosis
- Infectious spondylodiscitis
- Intravertebral resorption of hydroxyapatite discal calcification
- Metastasis to vertebra