Spinal Manifestations of Systemic Disease

Radiol Clin North Am. 2019 Mar;57(2):281-306. doi: 10.1016/j.rcl.2018.10.005. Epub 2018 Dec 27.


The spine is frequently involved in systemic diseases, including those with neuropathic, infectious, inflammatory, rheumatologic, metabolic, and neoplastic etiologies. This article provides an overview of systemic disorders that may affect the spine, which can be subdivided into disorders predominantly involving the musculoskeletal system (including bones, joints, disks, muscles, and tendons) versus those predominantly involving the nervous system. By identifying the predominant pattern of spine involvement, a succinct, appropriate differential diagnosis can be generated. The importance of reviewing the medical record, as well as prior medical imaging (including nonspine imaging), which may confer greater specificity to the differential diagnosis, is stressed.

Keywords: Infectious; Inflammatory; Metabolic; Neoplastic; Neuroimaging; Rheumatologic; Spine pathology; Systemic disease.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Musculoskeletal Diseases / diagnostic imaging*
  • Musculoskeletal Diseases / pathology
  • Nervous System Diseases / diagnostic imaging*
  • Nervous System Diseases / pathology
  • Spinal Diseases / diagnostic imaging
  • Spinal Diseases / pathology
  • Spine / pathology*
  • Tomography, X-Ray Computed / methods*