Romanus lesion

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Romanus lesion is a radiology sign seen in inflammatory spine conditions like ankylosing spondylitis. It describes erosion of the front (anterior) and back (posterior) ends of a vertebra, called the vertebral endplates.

The erosion most often affects the front of the vertebra, causing the front curve to flatten and the bone to look squared or barrel-shaped.

As the erosion heals, the damaged area becomes denser (sclerotic), creating a shiny corner sign. This can later contribute to the growth of bony bridges between vertebrae, known as syndesmophytes, and may help spine fusion develop.

MRI is usually better than X-rays at detecting Romanus lesions, especially in the early stages.

The lesion was first described by Ragnar Romanus and Sven Ydén in 1952.