Modic type 1 degenerative signal changes can mimic/suggest infection, leading to additional costly and sometimes invasive investigations.

A retrospective study analyzes the utility and accuracy of a novel, diffusion-weighted “claw sign” for distinguishing symptomatic type 1 degeneration from vertebral diskitis/osteomyelitis.

In patients with type 1 signal changes of the vertebral disk space, a claw sign is highly suggestive of degeneration and its absence strongly suggests diskitis/osteomyelitis ¹⁾.