Academy of Chiropractic’s
MD Relationship Program
#11 Clinical Information, Diagnosis and MRI
From: William J Owens Jr DC DAAMLP
Understanding the difference between and ACUTE or CHRONIC injury to the spine is a critical part of proper spine care. One of the ways to do that is to use the Modic scale to determine how long a reactive process has been present in the spine. If you do not know what these are you MUST TAKE THE MRI CERTIFICATION COURSE.
This is the link for course information. http://teachdoctors.com/index.php?option=com_content&view=article&id=170&Itemid=42
Here is a very brief reference sheet to help you. REMINDER – you need to review BOTH the T1 and the T2 weighted images to determine the Modic criteria.
Diagnosing modic changes
- In Modic type 1 there is vascular development in the vertebral body, with findings of inflammation and edema, but no trabecular damage or marrow changes.
- In Modic type 2 there are changes in bone marrow, with fatty replacement of formerly red, cellular marrow normally seen there. With Modic type 2 changes the marrow is substituted by visceral fat, the same kind of fat we have on our hips and bellies.
- Modic Changes type 3 are less common, with fractures of the trabecular bone, along with trabecular shortening and widening.
- Modic MT, Steinberg PM, Ross JS, et al. (1988). “Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging”. Radiology. 166 (1): 193–9. PMID 3336678. doi:10.1148/radiology.166.1.3336678.
- Modic MT, Masaryk TJ, Ross JS, Carter JR (1988). “Imaging af degererative disk disease”. Radiology. 168: 177–86. doi:10.1148/radiology.168.1.3289089.
- Albert HB (2008). “Modic changes, possible causes and relation to low back pain.”.”. Med Hypotheses. 70 (2): 361–8. PMID 17624684. doi:10.1016/j.mehy.2007.05.014.
- Albert HB (Jul 2007). “Modic changes following lumbar disc herniation.”.”. Eur Spine J. 16 (7): 977–82. PMC . PMID 17334791. doi:10.1007/s00586-007-0336-8.