Özlem ÇELİK AYDIN, Hatice Kübra ÖZDEMİR, Habibe ESER
Advanced Radiology and Imaging - 2026;3(2):32-37
Objectives: Degenerative intervertebral disc findings are well recognized in adults, but remain less clearly defined in pediatric patients, particularly when incidentally detected on magnetic resonance imaging (MRI). This study aimed to evaluate the prevalence, severity, and anatomical distribution of incidental degenerative lumbar disc findings in pediatric patients undergoing MRI for indications unrelated to degenerative spinal disease. Methods: This retrospective observational study included 73 pediatric patients who underwent abdominal, pelvic, or lumbar MRI examinations with adequate visualization of the lumbar spine. Patients with known spinal trauma, previous spinal surgery, congenital spinal malformation, infection, malignancy, inflammatory spondyloarthropathy, or whose MRI was performed primarily for suspected degenerative spinal disease were excluded. Intervertebral discs were evaluated on sagittal T2-weighted images according to the Pfirrmann classification. Disc-level distribution, number of affected discs, Modic-type endplate changes, disc bulging, protrusion, and extrusion, and demographic variables were recorded. Results: The study population consisted of 33 males (45.2%) and 40 females (54.8%), with a mean age of 11.8+/-4.2 years. Fifty-two patients (71.2%) had Pfirrmann grade 1 discs. Pfirrmann grade 2 and grade 3 degeneration were detected in 12 patients (16.4%) and 9 patients (12.3%), respectively. Overall, Pfirrmann grade 2 or higher disc degeneration was observed in 21 patients (28.8%). No Pfirrmann grade 4 or 5 degeneration was identified. Degenerative disc findings increased with age and were most frequent in the 13-17-year age group. No patient aged 6 years or younger showed disc degeneration. The affected levels were predominantly located in the lower lumbar spine, especially at L4-L5 and L5-S1. No marked sex-related differences were observed. Conclusion: Incidental degenerative lumbar disc findings may be detected in pediatric patients, particularly during adolescence. These findings are usually low-grade, are limited to Pfirrmann grade 2 or 3 changes, and predominantly involve the lower lumbar levels. Awareness of this imaging spectrum may help radiologists avoid both underrecognition and overinterpretation of incidental degenerative disc findings in pediatric MRI.
