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Hemispheric spondylosclerosis

Dr Francis Deng et al.

Hemispheric spondylosclerosis is a phenomenon in degenerative spine disease characterized by a focal dome-shaped sclerotic area at the anterior (usually inferior) corner of a single vertebral body.

Other terms for this condition include pseudoinfection of the intervertebral disk, localized vertebral condensation, discogenic vertebral sclerosis, idiopathic vertebral sclerosis, and idiopathic segmental sclerosis 2.

It is thought to represent a localized form of the Modic endplate degenerative changes 1. The original description considered infection and neoplasia as potential etiologies/mimics, but subsequent reports have not used this terminology in those settings 1,2.

There is a predilection for the anteroinferior corner of lumbar vertebral bodies, most frequently at L4 1,2.

The radiographic findings are as follows 2:

  • dome- or helmet-shaped sclerosis of the vertebral body adjacent to (usually above) the intervertebral disc
  • asymmetric erosions of the involved endplate
  • disc space narrowing
  • marginal osteophytes

The bone signal intensity is variable, as it is with different types of Modic endplate changes, and does not always correlate with the sclerosis seen on radiography/CT 1. Disc degenerative changes and endplate erosions are a consistent feature.

The imaging features were first described by W Dihlmann in 1981 2.

Rounded vertebral sclerosis abutting an endplate can be a feature of osteoblastic metastases, while endplate erosions can be a feature of spondylodiscitis.

Article information

rID: 87727
Synonyms or Alternate Spellings:
  • Idiopathic segmental sclerosis
  • Idiopathic vertebral sclerosis
  • Discogenic vertebral sclerosis
  • Localized vertebral condensation
  • Pseudoinfection of the intervertebral disk

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Cases and figures

  • Case 1: radiograph
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  • Case 2: MRI
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