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Spine
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Discogenic Back Pain

Degenerative Spine

A 38-year-old office worker presents with 18 months of axial low back pain without radicular symptoms. Pain is aggravated by sitting and flexion activities. MRI shows a Pfirrmann grade IV disc at L4/5 with high intensity zone (HIZ) in the posterior annulus. Neurological examination is normal. Previous physiotherapy and NSAIDs provided only partial relief. Regarding internal disc disruption and discogenic pain:

Mark each as TRUE or FALSE

A

Internal disc disruption (IDD) refers to structural disruption of the disc with radial annular tears...

B

The high intensity zone (HIZ) on T2-weighted MRI represents a radial tear of the annulus with granul...

C

Internal disc disruption always causes external disc bulging or herniation; MRI findings correlate p...

D

Modic type I changes show decreased T1 and increased T2 signal (edema/inflammation) and are associat...

E

Clinical features of discogenic pain include central or paracentral axial low back pain, aggravation...

Answer the questions to see explanations

Click T (True) or F (False) for each option