J Korean Soc Radiol.  2013 Apr;68(4):343-350. 10.3348/jksr.2013.68.4.343.

Posterior Lumbar Subcutaneous Edema on Spine Magnetic Resonance Images: What Is the Cause?

• Han GJ
• Lee IS
• Han IH
• Lee JS
• Moon TY
• Song JW

• KMID: 1425151
• DOI: http://doi.org/10.3348/jksr.2013.68.4.343

Abstract

PURPOSE
Posterior lumbar subcutaneous (PLS) edema on spine magnetic resonance (MR) images is a common incidental, though neglected finding. This study was undertaken to investigate the relations between PLS edema and pathologic conditions.
MATERIALS AND METHODS
Between January and December 2009, 138 patients with PLS edema, but without a spinal tumor or a history of recent surgery or trauma, and 80 infectious spondylitis patients without PLS edema were enrolled in this retrospective study. Available medical records and lumbar spine MR images were evaluated. The degree of edema was quantified using an arbitrary scoring system. Further, the correlations between the degree of edema and age, sex, body mass index (BMI), degeneration of posterior spinal structures (PSS) and infectious spondylitis were analyzed.
RESULTS
Of the 93 cases with a calculable BMI, 61 (66%) had a BMI of > 23 kg/m2. Correlations between the degree of edema and sex, age and BMI grade were all statistically non-significant. Thirty-three cases (24%) had an underlying disease, such as heart problem, diabetes mellitus, liver cirrhosis, chronic renal failure, extra-spinal tumor or connective tissue disorder. The numbers of cases with infectious spondylitis and an idiopathic condition was 61 (44%) and 44 (32%), respectively. The grade of infectious spondylitis was not found to be significantly associated with the degree of edema (p = 0.084). In cases with an idiopathic condition, the correlation between the degree of edema and PSS degeneration was statistically significant (p = 0.042).
CONCLUSION
Radiologists should not disregard PLS edema, because it is related to an underlying disease and thus may be of clinical significance.

MeSH Terms

Back Pain
Body Mass Index
Connective Tissue
Diabetes Mellitus
Edema
Heart
Humans
Kidney Failure, Chronic
Liver Cirrhosis
Lumbosacral Region
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Medical Records
Retrospective Studies
Spine
Spondylitis

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