claw sign

The claw sign on diffusion weighted imaging refers to a pattern of hyperintensity seen in degenerative changes in the spine (Modic type 1): well-defined, paired band-like regions of restricted diffusion affecting two contiguous vertebral bodies, resembling a claw surrounding the disc space on sagittal images. The presence of the claw sign is highly predictive of degeneration  and has a high negative predictive value against infection . In contrast, diffuse or amorphous DWI hyperintensity, absent a claw morphology, predicts infectious spondylodiskitis .

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