Discogenic lumbar pain: association with MR imaging and CT discography.
OBJECTIVE
To correlate MR and CT discography findings with pain response at provocative discography in patients with discogenic back pain.


METHODS
Forty-seven patients aged 25-54 years who underwent MR imaging and subsequent CT discography (97 discs) were included in this study. MR images were retrospectively evaluated regarding disc degeneration, endplate abnormalities, facet joint osteoarthritis, and high intensity zone. During discography concordant pain was regarded as positive, whereas discordant pain and no pain were regarded as negative. MR and CT discographic findings were analyzed on the base of concordant pain using the Chi-square test.


RESULTS
: Concordant pain was significantly common in the following (P < 0.05): grade 4 or 5 disc degeneration [88% (30/34) in concordant pain versus 48% (30/63) in discordant pain and no pain], high intensity zone [56% (19/34) versus 30% (19/63)], combination of above two findings [53% (18/34) versus 25% (16/63)], fissured and ruptured disc at discogram [94% (32/34) versus 57% (36/63)], and contrast beyond inner annulus at CT discogram [97% (33/34) versus 57% (36/63)].


CONCLUSIONS
Typical MR findings with concordant pain at discography include grade 4 or 5 disc degeneration and presence of a high intensity zone. Typical CT discography findings with concordant pain were fissured/ruptured discs and contrast extending into/beyond the outer annulus on CT.
Lim
Chae-Hun
CH
Department of Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, 137-701 Seoul, Korea.
Jee
Won-Hee
WH
Son
Byung Chul
BC
Kim
Dong-Hyun
DH
Ha
Kee-Yong
KY
Park
Chun-Kun
CK
D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology; D017116:Low Back Pain / Q000175:diagnosis* / Q000473:pathology; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed