title: Modic Type 1 Vertebral Endplate Changes: Injury, Inflammation, or Infection?
abstract: OBJECTIVE
  In the 29 years since the initial description of Modic type 1 vertebral endplate changes there has been ongoing debate regarding their cause. Studies have attributed Modic type 1 vertebral endplate changes to traumatic injury to the vertebral endplate, localized action of proinflammatory mediators, and more recently low-grade bacterial infection. Can we reconcile these conflicting data about the underlying cause of Modic type 1 vertebral endplate changes? Are we now in a position to conclude whether Modic type 1 vertebral endplate changes are secondary to injury, inflammation, or infection?
  
  
  CONCLUSIONS
  We argue that the processes are not disparate but are in fact closely linked, each potentially instigating a chain of events leading to the MRI findings of Modic type 1 vertebral endplate change. A method of delineating which process is predominantly at play in an individual patient is required so that tailored treatment options can be offered with huge potential benefit to individuals and society alike.
authors.affiliation: 1 Department of Radiology, Mater Misercordiae University Hospital, Eccles St, Dublin D7, Ireland.
authors.forename: Matthew Thomas
authors.initials: MT
authors.lastname: Crockett
authors.affiliation: 1 Department of Radiology, Mater Misercordiae University Hospital, Eccles St, Dublin D7, Ireland.
authors.forename: Brendan Sean
authors.initials: BS
authors.lastname: Kelly
authors.affiliation: 1 Department of Radiology, Mater Misercordiae University Hospital, Eccles St, Dublin D7, Ireland.
authors.forename: Susie
authors.initials: S
authors.lastname: van Baarsel
authors.affiliation: 1 Department of Radiology, Mater Misercordiae University Hospital, Eccles St, Dublin D7, Ireland.
authors.forename: Eoin Carl
authors.initials: EC
authors.lastname: Kavanagh
mesh_terms: D003287:Contrast Media; D015299:Discitis / Q000000981:diagnostic imaging / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D007249:Inflammation; D007403:Intervertebral Disc / Q000000981:diagnostic imaging* / Q000473:pathology*; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Modic type 1 vertebral endplate change; low-grade infection; mechanical stress; proinflammatory mediators