Bookmarks
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
- Anular bulge, annular bulge, bulging disc
Definitions
- Generalized extension of disc beyond edges of vertebral ring apophyses
- > 25% of disc circumference
- Typically extends < 3 mm beyond edge of apophyses
- Generalized extension of disc beyond edges of vertebral ring apophyses
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Nuclear Medicine Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
- Li Y et al: How should we grade lumbar disc herniation and nerve root compression? A systematic review. Clin Orthop Relat Res. 473(6):1896-902, 2015
- Fardon DF et al: Lumbar disc nomenclature: version 2.0: recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology, and the American Society of Neuroradiology. Spine (Phila Pa 1976). 39(24):E1448-65, 2014
- Hadjipavlou AG et al: The pathophysiology of disc degeneration: a critical review. J Bone Joint Surg Br. 90(10):1261-70, 2008
- Walker J 3rd et al: Discography in practice: a clinical and historical review. Curr Rev Musculoskelet Med. 1(2):69-83, 2008
- Modic MT et al: Lumbar degenerative disk disease. Radiology. 245(1):43-61, 2007
- Urban JP et al: Pathophysiology of the intervertebral disc and the challenges for MRI. J Magn Reson Imaging. 25(2):419-32, 2007
- Ido K et al: The validity of upright myelography for diagnosing lumbar disc herniation. Clin Neurol Neurosurg. 104(1):30-5, 2002
- Lebkowski WJ et al: Degenerated lumbar intervertebral disc. A morphological study. Pol J Pathol. 53(2):83-6, 2002
- Botwin KP et al: Role of weight-bearing flexion and extension myelography in evaluating the intervertebral disc. Am J Phys Med Rehabil. 80(4):289-95, 2001
- Fredericson M et al: Changes in posterior disc bulging and intervertebral foraminal size associated with flexion-extension movement: a comparison between L4-5 and L5-S1 levels in normal subjects. Spine J. 1(1):10-7, 2001
- Adams MA et al: Mechanical initiation of intervertebral disc degeneration. Spine. 25(13):1625-36, 2000
- Luoma K et al: Low back pain in relation to lumbar disc degeneration. Spine. 25(4):487-92, 2000
- Milette PC et al: Differentiating lumbar disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. Spine. 24(1):44-53, 1999
- Sambrook PN et al: Genetic influences on cervical and lumbar disc degeneration: a magnetic resonance imaging study in twins. Arthritis Rheum. 42(2):366-72, 1999
- Harada A et al: Correlation between bone mineral density and intervertebral disc degeneration. Spine. 23(8):857-61; discussion 862, 1998
- Cowan NC et al: The natural history of sciatica: a prospective radiological study. Clin Radiol. 46(1):7-12, 1992
- Maezawa S et al: Pain provocation at lumbar discography as analyzed by computed tomography/discography. Spine. 17(11):1309-15, 1992
- Ito S et al: An observation of ruptured annulus fibrosus in lumbar discs. J Spinal Disord. 4(4):462-6, 1991
- Bernard TN Jr: Lumbar discography followed by computed tomography. Refining the diagnosis of low-back pain. Spine. 15(7):690-707, 1990
- Tervonen O et al: Lumbar disc degeneration. Correlation between CT and CT/discography. Acta Radiol. 31(6):551-4, 1990
- Kambin P et al: Annular protrusion: pathophysiology and roentgenographic appearance. Spine. 13(6):671-5, 1988
- Sachs BL et al: Dallas discogram description. A new classification of CT/discography in low-back disorders. Spine. 12(3):287-94, 1987
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
- Anular bulge, annular bulge, bulging disc
Definitions
- Generalized extension of disc beyond edges of vertebral ring apophyses
- > 25% of disc circumference
- Typically extends < 3 mm beyond edge of apophyses
- Generalized extension of disc beyond edges of vertebral ring apophyses
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Nuclear Medicine Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
- Li Y et al: How should we grade lumbar disc herniation and nerve root compression? A systematic review. Clin Orthop Relat Res. 473(6):1896-902, 2015
- Fardon DF et al: Lumbar disc nomenclature: version 2.0: recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology, and the American Society of Neuroradiology. Spine (Phila Pa 1976). 39(24):E1448-65, 2014
- Hadjipavlou AG et al: The pathophysiology of disc degeneration: a critical review. J Bone Joint Surg Br. 90(10):1261-70, 2008
- Walker J 3rd et al: Discography in practice: a clinical and historical review. Curr Rev Musculoskelet Med. 1(2):69-83, 2008
- Modic MT et al: Lumbar degenerative disk disease. Radiology. 245(1):43-61, 2007
- Urban JP et al: Pathophysiology of the intervertebral disc and the challenges for MRI. J Magn Reson Imaging. 25(2):419-32, 2007
- Ido K et al: The validity of upright myelography for diagnosing lumbar disc herniation. Clin Neurol Neurosurg. 104(1):30-5, 2002
- Lebkowski WJ et al: Degenerated lumbar intervertebral disc. A morphological study. Pol J Pathol. 53(2):83-6, 2002
- Botwin KP et al: Role of weight-bearing flexion and extension myelography in evaluating the intervertebral disc. Am J Phys Med Rehabil. 80(4):289-95, 2001
- Fredericson M et al: Changes in posterior disc bulging and intervertebral foraminal size associated with flexion-extension movement: a comparison between L4-5 and L5-S1 levels in normal subjects. Spine J. 1(1):10-7, 2001
- Adams MA et al: Mechanical initiation of intervertebral disc degeneration. Spine. 25(13):1625-36, 2000
- Luoma K et al: Low back pain in relation to lumbar disc degeneration. Spine. 25(4):487-92, 2000
- Milette PC et al: Differentiating lumbar disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. Spine. 24(1):44-53, 1999
- Sambrook PN et al: Genetic influences on cervical and lumbar disc degeneration: a magnetic resonance imaging study in twins. Arthritis Rheum. 42(2):366-72, 1999
- Harada A et al: Correlation between bone mineral density and intervertebral disc degeneration. Spine. 23(8):857-61; discussion 862, 1998
- Cowan NC et al: The natural history of sciatica: a prospective radiological study. Clin Radiol. 46(1):7-12, 1992
- Maezawa S et al: Pain provocation at lumbar discography as analyzed by computed tomography/discography. Spine. 17(11):1309-15, 1992
- Ito S et al: An observation of ruptured annulus fibrosus in lumbar discs. J Spinal Disord. 4(4):462-6, 1991
- Bernard TN Jr: Lumbar discography followed by computed tomography. Refining the diagnosis of low-back pain. Spine. 15(7):690-707, 1990
- Tervonen O et al: Lumbar disc degeneration. Correlation between CT and CT/discography. Acta Radiol. 31(6):551-4, 1990
- Kambin P et al: Annular protrusion: pathophysiology and roentgenographic appearance. Spine. 13(6):671-5, 1988
- Sachs BL et al: Dallas discogram description. A new classification of CT/discography in low-back disorders. Spine. 12(3):287-94, 1987
