Claw sign (spine)

Last revised by Francis Deng on 7 Oct 2020

The claw sign on diffusion weighted imaging refers to a pattern of hyperintensity seen in degenerative changes in the spine (Modic type 1): well-defined, paired band-like regions of restricted diffusion affecting two contiguous vertebral bodies, resembling a claw surrounding the disc space on sagittal images. The presence of the claw sign is highly predictive of degeneration 1-3 and has a high negative predictive value against infection 4. In contrast, diffuse or amorphous DWI hyperintensity, absent a claw morphology, predicts infectious spondylodiscitis 1-3.

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Cases and figures

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