When evaluating a spine MRI for degenerative disc disease, a radiologist first looks for signs of disc desiccation, which is the loss of water content within the spinal disc. On a standard T2-weighted MRI scan, healthy, fluid-rich discs absorb light differently and appear bright white. As a disc degenerates and dries out, it loses this fluid signal and turns dark gray or black. Alongside this color change, the radiologist checks for a loss of disc height, measuring how much the cushion between the vertebrae has thinned and narrowed. They also look for structural structural changes in the surrounding bone, such as endplate sclerosis (thickening of the bone adjacent to the disc) and the formation of osteophytes (bone spurs) reacting to the increased friction.
Beyond the disc itself, the radiologist carefully assesses how these degenerative changes impact the surrounding spinal anatomy. They look for structural displacement like a disc bulge or a focal herniation, where the disc material expands or protrudes past its normal boundaries. The scan is then checked for foraminal stenosis—the narrowing of the small side openings where nerve roots exit the spine—and central canal stenosis, which is a tightening of the main spinal canal. By identifying whether these bulges or bone spurs are causing nerve root compression, the radiologist can help explain clinical symptoms like radiating leg or arm pain. Crucially, because disc degeneration is a normal part of aging, radiologists document these structural findings objectively, knowing they must be paired with a patient’s physical symptoms for an accurate clinical diagnosis.