Imaging psoas sign (spondylodiscitis)

Last revised by Liz Silverstone on 3 Feb 2025

The imaging psoas sign refers to high T2 signal intensity in the psoas muscle which is commonly associated with spondylodiscitis and is a helpful sign in the appropriate clinical context. The psoas muscles have variable origin and attachments 2 to the transverse processes and anteromedial disc and vertebral bodies, commonly T12 to L5.

Other inflammatory and some neoplastic conditions can cause T2 hyperintensity in the psoas muscle, for example myositis and ankylosing spondylitis 1. The original paper 1 demonstrated high sensitivity and specificity in biopsy-confirmed cases of spondylodiscitis however the sign has not been independently validated.

History and etymology

The imaging psoas sign was first described in 2016 by Luke Ledbetter, an American neuroradiologist and his colleagues 1

Cases and figures

  • Case 1
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