Age / Sex : 44 / M

Age / Sex : 44 / M

Chief complaint : Lower back pain for 1 year

Discussion

Findings:

Sagittal lumbar MR images showed low signal intensity on T1-weighted and high signal intensity on T2-weighted images at the superior and inferior portions of lumbar vertebral bodies. Mild contrast enhancement is also seen. These findings are consistent with edematous hyperemic inflammation lesion.

Differential Diagnosis:

Degenerative corner lesion

Diagnosis:  

Ankylosing spondylitis (Romanus lesion, MR corner sign)

Discussion:

Focal destructive areas along the anterior margin of the discovertebral junction at the superior and inferior portions of vertebral body are early and significant features of ankylosing spondylitis, and have been termed “Romanus lesions”

The MR corner sign is defined as a nonerosive edematous inflammatory lesion at vertebral corners, a type of Romanus lesion. This lesion can be considered as an enthesitis at the site of attachment of annulus fibrosus to the vertebral endplate.

Degenerative corner lesions are semicircular shape and are always associated with adjacent disc degeneration.

References:

Kim NR, Choi JY, Hong SH, et al. "MR corner sign": value for predicting presence of ankylosing spondylitis. AJR Am J Roentgenol 2008;191:124-128