The pearls and pitfalls of magnetic resonance imaging for the spine

• Published in: The journal of orthopaedic and sports physical therapy 2011-11, Vol.41 (11), p.848-860
• Main Authors: Elliott, James M, Flynn, Timothy W, Al-Najjar, Aiman, Press, Joel, Nguyen, Bao, Noteboom, J Timothy
• Format: Article
• Language: English
• Subjects: Back Pain - diagnosis; Back Pain - pathology; Cervical Vertebrae; Humans; Lumbosacral Region - pathology; Magnetic Resonance Imaging - adverse effects; Magnetic Resonance Imaging - instrumentation; Musculoskeletal Diseases - diagnosis; Musculoskeletal Diseases - pathology; Spinal Injuries - diagnosis; Spinal Injuries - pathology; Spine - pathology; Thoracic Vertebrae - pathology; Tomography, X-Ray Computed - adverse effects; Tomography, X-Ray Computed - instrumentation
• ISSN: 0190-6011; 1938-1344
• DOI: 10.2519/jospt.2011.3636

Musculoskeletal imaging of the spine can be an invaluable tool to inform clinical decision making in patients with spinal pain. An understanding of the technology involved in producing and interpreting high-resolution images produced from magnetic resonance imaging (MRI) of the human spine is necessary to better appreciate which sequences can be used for, or tailored to, individual patients and their conditions. However, there is substantial variability in the clinical meaningfulness of some MRI findings of spinal tissues. For example, normal variants can often mimic significant musculoskeletal pathology, which could increase the risk of misinformed clinical decisions and, even worse, poor or adverse outcomes. This clinical commentary will highlight some of the pearls and pitfalls of MRI for the cervical, thoracic, and lumbar regions, and include cases to illustrate some of the common imaging artifacts and normal variants for MRI of the spine.