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Figures
- Fig 1.
The imaging psoas sign on noncontrast MR imaging of the lumbar spine in an 81-year-old man with renal failure, E faecalis bacteremia, and clinically diagnosed discitis-osteomyelitis (A and B) with comparison with degenerative disc disease (C and D). A, Sagittal T2 image demonstrates high T2 signal within the disc (white arrow) and the adjacent endplates (white curved arrow) in the patient with discitis-osteomyelitis. B, Axial T2 image at the level of L3–L4 of the same patient demonstrates the imaging psoas sign of T2 hyperintensity within the bilateral psoas musculature (white arrows). C, Sagittal T2 image in a patient with degenerative disc disease shows focal high T2 signal involving the posterior endplate and disc of L4–L5 (white arrow). D, Axial T2 image in the same patient at the level of L4–L5 shows normal and uniform T2 signal within the psoas muscles (white arrow).
- Fig 2.
The imaging psoas sign in biopsy-proved S aureus discitis-osteomyelitis in a 79-year-old man with history of long-term steroid treatment of hypersensitivity pneumonitis. A, Sagittal T1 image shows height loss of L2 with associated increased L2–L3 disc space height. Normal T1 hypointensity is absent along the inferior L2 endplate due to destruction (white open arrow). B, Sagittal T2 image demonstrates subtle L2 marrow T2 hyperintensity (white arrow). C, Sagittal STIR image shows increased conspicuity of T2 hyperintensity within the L2–L3 disc space (white arrow). D, Axial T2 image at the level of the superior L3 vertebral body demonstrates bilateral psoas muscle hyperintense signal, the imaging psoas sign (white arrows).
Tables
Spinal Infection (n = 51) Controls (n = 50) Age (yr) (range) 58.8 (19–87) 53.6 (18–93) Sex 41 Male, 10 female 25 Male, 25 female Previous spinal surgery 12 6 Contrast-enhanced exams 45 39 Non-contrast-enhanced exams 6 11 κ Coefficient Agreement Psoas abscess 0.87 Almost Perfect Psoas enhancement 0.81 Almost Perfect Psoas T2a 0.78 Substantial Vertebral body T2 hyperintensity 0.76 Substantial Vertebral body T1 hypointensity 0.75 Substantial Vertebral body enhancement 0.75 Substantial Disc T2 hyperintensity 0.73 Substantial Endplate destruction 0.67 Substantial Epidural phlegmon 0.59 Moderate Epidural abscess 0.58 Moderate Disc enhancement 0.50 Moderate Disc increased height 0.44 Moderate ↵a Imaging psoas sign..
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