Modic Classification of Vertebral Endplate / Marrow Changes
Modic changes describe degenerative signal change in the vertebral bone marrow adjacent to the endplate, classified into three types by their T1/T2 appearance: Type 1 (edema/inflammation — T1 dark, T2 bright), Type 2 (fatty marrow conversion — T1 bright, T2 iso-to-bright), and Type 3 (sclerosis — dark on both). Type 1 in particular is linked to low back pain and is the one that most often prompts a second look, including in the differential against infective spondylodiscitis. A compact, high-traffic term that spine reports lean on.
Introduced types 1–3 of vertebral endplate/marrow signal change (edema, fatty conversion, sclerosis) on T1/T2 MRI (Radiology 1988); type 1 is the one linked to back pain and the infection differential.
In axial spondyloarthritis, degenerative spine lesions progress in a specific sequence: MRI disk degeneration strongly predicted later herniation (OR 3.97), Modic type 1 predicted Modic type 2 (OR 49.36), and MRI lesions predicted radiograph lesions at the same level (OR 2.49).
RadPigeon is an independent radiology news digest and is not affiliated with or endorsed by Modic et al.. “Modic changes” is a trademark of its owner and is named here only to refer to the system. Always consult the official source for the exact, current criteria.
