The results of this review demonstrate that tests do exist that change the probability of the disc or SIJ ( but not the facet joint ) as the source of low back pain .
Clinical practice guidelines state that the tissue source of low back pain can not be specified in the majority of patients .
However , there has been no systematic review of the accuracy of diagnostic tests used to identify the source of low back pain .
The aim of this systematic review was therefore to determine the diagnostic accuracy of tests available to clinicians to identify the disc , facet joint or sacroiliac joint ( SIJ ) as the source of low back pain .
Diagnosis of Symptomatic Disc by Magnetic Resonance Imaging: T2-Weighted and Gadolinium-DTPA-Enhanced T1-Weighted Magnetic Resonance Imaging
Although radial tear of the annulus fibrosus can be detected on T2-weighted and Gd-DTPA-enhanced magnetic resonance ( MR ) images , the association between the annular tear on MR images and the symptomatic discs is unclear . The purpose of this study was to investigate the relationship between T2-weighted , gadolinium-DTPA-enhanced MR images and pain response through discography in patients with chronic low back pain . A total of 56 lumbar discs from 23 patients with chronic low back pain ( 13 to 47 years old ) underwent MR imaging ( T2-weighted , gadolinium-DTPA-enhanced MR images ) followed by provocative discography . The sensitivity , specificity , positive predictive value , and negative predictive value of T2-weighted and gadolinium-DTPA-enhanced MR images in detecting the symptomatic discs were calculated . The sensitivity , specificity , positive predictive value , and negative predictive value of T2-weighted images in detecting the symptomatic disc were 94 % , 71 % , 59 % , and 97 % , respectively . The sensitivity , specificity , positive predictive value , and negative predictive value of gadolinium-DTPA-enhanced images were 71 % , 75 % , 56 % , and 86 % , respectively . The high sensitivity and the high negative predictive value of T2-weighted MR imaging in detecting the symptomatic disc indicated that MR imaging can be a useful screening tool in avoiding unnecessary discography in patients with chronic low back pain
The results of this review demonstrate that tests do exist that change the probability of the disc or SIJ ( but not the facet joint ) as the source of low back pain .
Clinical practice guidelines state that the tissue source of low back pain can not be specified in the majority of patients .
However , there has been no systematic review of the accuracy of diagnostic tests used to identify the source of low back pain .
The aim of this systematic review was therefore to determine the diagnostic accuracy of tests available to clinicians to identify the disc , facet joint or sacroiliac joint ( SIJ ) as the source of low back pain .