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. 2011 Oct;32(9):1624–1631. doi: 10.3174/ajnr.A2588

Fig 3.

Fig 3.

Type 1 pedicle marrow signal intensity changes associated with evolving pedicle fractures in a 13-year-old male adolescent. A, Left type 1 pedicle marrow signal intensity changes, which are best appreciated on the STIR sequence. From top to bottom, each row shows T1-, T2-, and STIR-weighted sequences. The MR study on February 9, 2005, demonstrates increased signal intensity within the left pedicle and proximal superior facet, which is best appreciated on the STIR sequence (arrow). He was treated conservatively and the back pain improved. The follow-up study on March 23, 2005, demonstrates some improvement in the hyperintensity of the left L5 pedicle. A follow-up MR study on August 4, 2005, demonstrates increased type 1 pedicle marrow changes of L5 bilaterally with a fracture line at the junction of the pedicle and superior articular facets (arrow). A follow-up study from February 20, 2006, shows some improvement of the increased signal intensity on STIR and T2 (arrows), and the previous fracture line is no longer appreciated. Similar changes were seen on the right. The patient's back pain was less severe but still present. B, Axial T2 MR images (top row) through the L5 pedicle on February 9, 2005, and August 4, 2005, and axial CT images (bottom row) through the L5 pedicle on February 18, 2005, and August 8, 2005. The CT obtained on February 18, 2005, was read as negative for fracture. The follow-up MR image demonstrates bilateral fracture lines through the L5 pedicles. The follow-up CT from August 8, 2005, shows clearly demarcated fractures through the junction of the pedicle and superior facet of L5 bilaterally (arrows).