Fig 5.

Sequential lumbar MR images obtained 30 months apart in a 15-year-old male patient with back pain, highlighting progressive disc degeneration despite the resolution of bony stress reaction. Initial MR imaging revealed edema in the right L5 pedicle (thick arrow) as shown here on a parasagittal STIR image, consistent with a stress reaction. Sagittal T2WI at this time revealed subtle annular fissures at the L4–5 and L5–S1 discs (small arrows) and signs of nuclear degeneration at the L5–S1 level. Follow-up MR imaging obtained 30 months later reveals the resolution of pedicular edema (thick arrow), but progressive loss of nuclear signal intensity of both stressed discs at the L4–5 and L5–S1 levels. Note that the control disc at the L3–4 level remains normal.