Correlation of low back pain to a high-intensity zone of the lumbar disc in Indian patients.

PURPOSE To assess the correlation between low back pain and a high-intensity zone (HIZ) of the lumbar disc in Indian patients. METHODS 200 patients with low back and/or leg pain underwent magnetic resonance imaging of the lumbosacral spine. The location and severity of pain and disability were assessed using the pain drawing, visual analogue scale, and Oswestry Disability Index, respectively. The inter-observer reliability was assessed using the kappa statistic. RESULTS. The prevalence of an HIZ was 13% and 17% according to observers A and B, respectively. The inter-observer reliability was fair (kappa=0.64, p<0.005). The presence of an HIZ did not correlate with low back pain according to the pain drawing, visual analogue scale, and Oswestry Disability Index. According to the pain drawing data, the sensitivity, specificity, and positive predictive values of an HIZ to low back pain were 11%, 82%, and 62%, respectively. CONCLUSION The presence of an HIZ is not diagnostic of a disrupted and painful disc, and should be interpreted together with other prevailing symptoms and clinical findings.