title: High-intensity zone: a diagnostic sign of painful lumbar disc on magnetic resonance imaging.
abstract: The prevalence, validity and reliability of high-intensity zones in the annulus fibrosus seen on T2-weighted magnetic resonance images of patients with intractable low-back pain were determined. This sign was readily recognized by two independent observers. It occurred in 28% of 500 patients undergoing magnetic resonance imaging for back pain. The presence of a high-intensity zone correlated significantly with the presence of Grade 4 annular disruption and with reproduction of the patient's pain. Its sensitivity as a sign of either annular disruption or pain was modest but its specificity was high, and its positive predictive value for a severely disrupted, symptomatic disc was 86%. This sign is diagnostic of painful internal disc disruption.
authors.affiliation: Diagnostic Conservative Management, New Orleans.
authors.forename: C
authors.initials: C
authors.lastname: Aprill
authors.forename: N
authors.initials: N
authors.lastname: Bogduk
mesh_terms: D001416:Back Pain / Q000209:etiology; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D015588:Observer Variation; D014057:Tomography, X-Ray Computed