Uncommon Faces of Disc Herniation: Atypical Imaging Presentations and Mimics

Disc herniation is a prevalent pathology encountered in routine clinical practice. Commonly observed pathologic conditions such as disc protrusion, extrusion, migration, and sequestration are familiar to most radiologists and are frequently documented in standard radiology reports. However, disc herniation can exhibit a broad spectrum of imaging features, which may pose diagnostic challenges for radiologists. This case-based review aims to present intriguing cases with atypical imaging presentations of disc herniation, including extraforaminal herniation with a pseudotumoral appearance, massively calcified thoracic disc herniation, posttraumatic acute herniation, gas-containing disc herniation, cement leakage postvertebroplasty simulating disc herniation, and triple cervical disc treatment following sequential development of adjacent segment disease. By discussing their imaging features, we aim to distinguish the differential diagnosis of disc herniation from other entities and thus decrease the incidence of diagnostic errors. Additionally, we seek to provide a comprehensive visual resource that could be of Important educational value in daily clinical practice.