Thoracic discography. A safe and reliable technique.
OBJECTIVE
To evaluate the safety and reliability of discography used to investigate thoracic disc degeneration observed on magnetic resonance (MR) imaging studies in patients with clinical pain, we analyzed retrospectively the results of thoracic discograms performed on 100 outpatients.


METHODS
After MR imaging, clinically suspect, morphologically abnormal thoracic discs and at least one, nearby, control level were injected with either nonionic contrast or saline, filmed, and individually described by the patient as concordant versus nonconcordant relative to clinical pain and rated in intensity on a scale of 0-10.


RESULTS
There were no serious complications in the series, and the authors resolved whether the injected discs related to pain in each case. They found discs with anular tears, intrinsic degeneration, and/or associated vertebral body endplate infractions to be painful approximately 75% of the time. Clinical concordance was approximately 50%. Control levels were usually painless.


CONCLUSIONS
They conclude that thoracic discography can be performed safely by experienced individuals as a reliable tertiary diagnostic procedure to determine if degenerated discs on MR studies are related to clinical complaints.
Schellhas
K P
KP
Center for Diagnostic Imaging, St. Louis Park, Minnesota.
Pollei
S R
SR
Dorwart
R H
RH
D000293:Adolescent; D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging* / Q000473:pathology; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D007472:Iohexol; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology
D007472:Iohexol