Discogenic vertebral sclerosis is one of the skeletal "do not touch" lesions and should not be confused with a metastatic lesion or disc space infection. It can lead to an unnecessary biopsy.
The typical clinical presentation is a middle-aged female with chronic low back pain.
Discogenic vertebral sclerosis is often a sclerotic and focal lesion (but it can be lytic or even mixed lytic-sclerotic) which is always adjacent to the endplate, and the associated disc space should be narrow. Osteophytes may be present.
In the setting of disc space narrowing and osteophytosis, focal sclerosis adjacent to an endplate should not undergo biopsy.
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