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Han, Lee, Han, Lee, Moon, and Song: Posterior Lumbar Subcutaneous Edema on Spine Magnetic Resonance Images: What Is the Cause?
Musculoskeletal Radiology
Journal of the Korean Society of Radiology

Journal of the Korean Society of Radiology 2013; 68(4): 343-350.

Published online: 10 April 2013

DOI: https://doi.org/10.3348/jksr.2013.68.4.343

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

Ga Jin Han, MD1, In Sook Lee, MD1, In Ho Han, MD2, Jung Sub Lee, MD3, Tae Yong Moon, MD4, Jong Woon Song, MD5

1Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

2Department of Neurosurgery, Pusan National University Hospital, Busan, Korea.

3Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea.

4Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.

5Department of Radiology, Inje University Haeundae Paik Hospital, Busan, Korea.

Corresponding author: In Sook Lee, MD. Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 602-739, Korea. Tel. 82-51-240-7354, Fax. 82-51-244-7534, lis@pusan.ac.kr

Received 6 December 2012       Accepted 1 February 2013

Copyright © 2013 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Edema, Lumbosacral Region, Magnetic Resonance Imaging, Back Pain, Infectious Spondylitis

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