How can MRI differentiate between infectious spondylodiscitis and degenerative disc disease?

Degenerative disc disease typically shows Type 2 Modic changes with low T1 and high T2 signal intensity at the endplates, often with preserved disc height. In contrast, disc space infection (spondylodiscitis) presents with high T2 signal intensity in the disc, low T1 signal, and often involves adjacent vertebral body endplates with enhancement after contrast administration. Clinical pearl: Look for paravertebral soft tissue changes or abscess formation in infections. Pitfall: Modic Type 1 changes can mimic infection due to similar signal characteristics.