From Modic 1 vertebral-endplate subchondral bone signal changes detected by MRI to the concept of 'active discopathy'

Ann Rheum Dis. 2015 Aug;74(8):1488-94. doi: 10.1136/annrheumdis-2015-207317. Epub 2015 May 14.


Late-1980s MRI-detected vertebral-endplate subchondral bone signal changes associated with degenerative disc disease as well as recent studies suggest that in some patients, non-specific chronic low back pain (NS cLBP) can be defined by specific clinical, radiological and biological features, for a concept of active discopathy. This concept allows for associating a particular NS cLBP phenotype to a specific anatomical lesion, namely those with Modic 1 signal changes seen on MRI. Local inflammation is thought to play a pivotal role in these changes. Other etiopathogenic processes may include local infection and mechanical or biochemical stress combined with predisposing genetic factors; treatment strategies remain debated. Modic 1 changes detected by MRI can be considered a first biomarker in NS cLBP. Such changes are of high clinical relevance because they are associated with a specific clinical phenotype and can be targeted by specific treatments.

Keywords: Low Back Pain; Magnetic Resonance Imaging; Spondyloarthritis.

Publication types

  • Review

MeSH terms

  • Humans
  • Intervertebral Disc Degeneration / pathology*
  • Intervertebral Disc Displacement / physiopathology
  • Low Back Pain / pathology*
  • Lumbar Vertebrae / pathology
  • Magnetic Resonance Imaging / classification*
  • Spine / pathology*
  • Spondylitis, Ankylosing / pathology