Claw sign (spine)
Citation, DOI, disclosures and article data
Citation:
Smith H, Deng F, Kabra U, et al. Claw sign (spine). Reference article, Radiopaedia.org (Accessed on 14 Jan 2025) https://doi.org/10.53347/rID-65516
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rID:
65516
Article created:
12 Jan 2019,
Hamish Smith
Disclosures:
At the time the article was created Hamish Smith had no recorded disclosures.
View Hamish Smith's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Francis Deng had no recorded disclosures.
View Francis Deng's current disclosures
Revisions:
4 times, by
4 contributors -
see full revision history and disclosures
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Synonyms:
- DWI claw sign
- Claw sign
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.
References
- 1. Patel KB, Poplawski MM, Pawha PS, Naidich TP, Tanenbaum LN. Diffusion-weighted MRI "claw sign" improves differentiation of infectious from degenerative modic type 1 signal changes of the spine. (2014) AJNR. American journal of neuroradiology. 35 (8): 1647-52. doi:10.3174/ajnr.A3948 - Pubmed
- 2. Daghighi MH, Poureisa M, Safarpour M, Behzadmehr R, Fouladi DF, Meshkini A, Varshochi M, Kiani Nazarlou A. Diffusion-weighted magnetic resonance imaging in differentiating acute infectious spondylitis from degenerative Modic type 1 change; the role of b-value, apparent diffusion coefficient, claw sign and amorphous increased signal. (2016) The British journal of radiology. 89 (1066): 20150152. doi:10.1259/bjr.20150152 - Pubmed
- 3. Muñoz Montoya JE, Pérez Cataño C, Tapicha Cuellar AM, Vargas Osorio MP, Rivero Cano J, Luque Suarez JC, Charry Lopez ML. Utility of the claw sign in spine magnetic nuclear resonance with diffusion to differentiate Modic type I changes for degenerative disease versus infection. (2018) Journal of spine surgery (Hong Kong). 4 (3): 616-623. doi:10.21037/jss.2018.07.06 - Pubmed
- 4. Laur O, Mandell JC, Titelbaum DS, Cho C, Smith SE, Khurana B. Acute Nontraumatic Back Pain: Infections and Mimics. (2019) Radiographics : a review publication of the Radiological Society of North America, Inc. 39 (1): 287-288. doi:10.1148/rg.2019180077 - Pubmed
- 5. Ridley LJ, Han J, Ridley WE, Xiang H. Claw sign: MRI of degenerative disc disease. (2018) Journal of medical imaging and radiation oncology. 62 Suppl 1: 125. doi:10.1111/1754-9485.06_12786 - Pubmed
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