Fig. 1

The first lumbar MRI. The sagittal T1WI (a) and the sagittal T2WI (b) show irregularities and lesions with marked hypointensity of the L2-–L3 vertebral body endplates, representing a loss of normal bone marrow signal on the T1WI (simple arrows) and sclerosis on the T2WI (open arrows). There is a slight retrolisthesis of the L2 vertebral body, suggesting some grade of instability. The gross morphology and height of the involved vertebral bodies are still preserved. There are associated degenerative changes with marginal osteophytes, important reduction of the L2–L3 intervertebral disc height and its T2WI signal, depicting disc dehydration, findings also observed at other levels of the thoracolumbar spine. The sagittal STIR-WI (c) demonstrate hyperintensity at the borders of the lesions, indicating oedema, a finding also observed on the T2WI in a subtler way (open arrows). The axial T2WI (d) show an enlargement of paravertebral surrounding soft tissues, suggestive of inflammation (double arrows). The sagittal (e) and axial (f) gadolinium-enhanced fat sat T1WI demonstrate subtle marginal enhancement of the vertebral body lesions and of the areas adjacent to interapophyseal articulations and spinous processes, from L2–L3 to L5–S1, compatible with the involvement of both anterior and posterior elements (simple arrows). The paravertebral enlarged soft tissues are also enhanced