Plain films (more common in infections anterior to dura). Look for lytic lesions, demineralization, and scalloping of endplates (may take 4–6 weeks after onset of infection).

Changes take from 2–8 weeks from the onset of infection to develop. Earliest changes are loss of cortical endplate margins and loss of disc space height.

In patients with suspected spine infection, ADC values on DWI are significantly reduced in those patients with positive microbiological sampling compared to patients with negative microbiological sampling. The DWI of the spine correlates well with the presence or absence of spinal infection and may complement conventional magnetic resonance imaging (MRI) ¹⁾.