So far no cases of nephrogenic systemic fibrosis (NSF) have been published on macrocyclical gadolinium-based contrast media (Gd-CM), assumed as low NSF risk CM due to their complex stability. In our haemodialysis-dependent patient, the first symptoms indicating NSF appeared about 16 months after the exposure to Gadovist, a macrocyclical Gd-CM, and 1 month after x-ray angiography with iodinated CM (Ultravist). This indicates that in addition to excretory renal failure and Gd-CM exposure, the loss of biosynthetic renal function could be essential for NSF development. A hypothesis of possible pathways involved in the development of NSF is presented.

Degenerative diseases of the lumbar spine have a high medical and socioeconomic impact. The leading symptom is back pain, but there are many reasons for this. The aim of this paper is to describe the pathogenesis of degenerative diseases of the lumbar spine and their clinical symptoms in relation to the functional anatomy and biomechanics of the spine. Discs, vertebral facet joints, osseous and ligamentous structures as well as the erector trunci muscles are a functional unit. Progressive degenerative changes of the discs induce bone overgrowth and ligamentous thickening, affect the orientation of the vertebral facet joints and change the pressure, tension and shear forces of the spine. The different radiological diagnostic tools are presented and discussed according to the different degenerative diseases of the lumbar spine.

Degenerative diseases of the lumbar spine have a high medical and socioeconomic impact. The leading symptom is back pain, but there are many reasons for this. The aim of this paper is to describe the pathogenesis of degenerative diseases of the lumbar spine and their clinical symptoms in relation to the functional anatomy and biomechanics of the spine. Discs, vertebral facet joints, osseous and ligamentous structures as well as the erector trunci muscles are a functional unit. Progressive degenerative changes of the discs induce bone overgrowth and ligamentous thickening, affect the orientation of the vertebral facet joints and change the pressure, tension and shear forces of the spine. The different radiological diagnostic tools are presented and discussed according to the different degenerative diseases of the lumbar spine.