posterior annulus

Posterior Annulus and the High Intensity Zone – Research looks to sub-classify this MRI finding

Discogenic pain is quite common. A finding on MRI that has been hotly debated is a hyperintensity zone, often seen within the posterior annulus of the intervertebral discs.

In a recent study published in PLOS One 1 researchers conducted the first large scale study to identify subclassifications of high intensity zones (HIZ). They looked at a cross sectional study of 814 participants both using T1 and T2 weighted imaging and created a morphological and topographical classification system. Findings included HIZs on the posterior annulus and anterior annulus.

High Intensity Zone, HIZ, Lumbar Disc, posterior annulus

They believe the results could help in the standardization of MRI findings in clinical and research settings.

MRI has been thought to be not very helpful in the early management of back pain. However, more research (like this) to extract MRI findings should help localize pain generators and direct patient care and treatments. Even if imaging is thought to be less than optimal in the early management of back pain 2 it is still important to look carefully at MRI and correlate a patient’s symptoms to help direct patient care. Otherwise, it is a bit of guessing game which structures are inflamed.

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Francis W. Smith MD Clinical Professor of Radiology Positional MRI Centre Woodend Hospital Aberdeen, Scotland