[Correlation between high intensity zone on MRI and positive pain response on lumbar discography in the diagnosis of discogenic low back pain].
OBJECTIVE
To study correlation between high intensity zone (HIZ) of lumbar disc and positive pain response on lumbar discography for the diagnosis and treatment of discogenic low back pain.


METHODS
Thirty-seven cases with chronic low back pain without neurologic symptoms and lumbar disc herniation on CT scan underwent lumbar discography and MRI examination. X-ray and CT after discography with positive pain response were analyzed to correlate with HIZ on MRI.


RESULTS
Ninety-eight discs underwent discography in 37 patients. Twenty-one discs presented positive pain response; including 10 have HIZ (47.6%). Seventy-seven discs presented negative pain response; including 29 had HIZ (37.6%). The higher grade of annular disruption group had the higher proportion of HIZ on lumbar MRI. There was a positive correlation between HIZ and degree of annular disruption. However, there was no correlation between HIZ and positive pain response on lumbar discography.


CONCLUSIONS
HIZ on lumbar MRI only can be a filtrated and suggestive image sign and can not replace discography in the diagnosis and treatment of discogenic low back pain.
Wang
Hua-Dong
HD
Department of Orthopaedics, the First Affiliated Hospital of General Hospital of People's Liberation Army, Beijing 100037, China. ortho@yeah.net
Hou
Shu-Xun
SX
Wang
Xiao-Ning
XN
Li
Zhen-Zhou
ZZ
Wu
Wen-Wen
WW
D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging*; D017116:Low Back Pain / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D011859:Radiography; D012680:Sensitivity and Specificity