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High-intensity zone: a diagnostic sign of painful lumbar disc on magnetic resonance imaging

1992; Wiley; Volume: 65; Issue: 773 Linguagem: Inglês

10.1259/0007-1285-65-773-361

1748-880X

Charles N. Aprill, Nikolai Bogduk,

Anesthesia and Pain Management

Abstract The prevalence, validity and reliability of high-intensity zones in the annulus fibrosus seen on T 2-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 highintensity 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.