Discography

About This Test

During a discography imaging test, the patient receives an injection of contrast dye in the center of a disc under X-ray control. While it is typically not a painful procedure, local anesthetics are used to minimize discomfort. Patients with positive discograms, however, will likely experience temporary pain - lasting a few minutes - during the disc injection.

Diagnosing disc pain with discography

Discography is used to determine whether back pain is coming from a disc as well as identify abnormalities in the disc. Abnormalities may include disc herniation, tears or fissures. These abnormalities are clinically significant if, when manipulated, they reproduce the patient's pain.

Patients that have significant back pain that is not relieved from conservative pain management techniques are candidates for discography. Conservative pain management for the back usually includes medication, physical therapy and epidural steroid injections. Before a discography, patients should also have had an MRI scan to identify disc abnormalities.

Reproducing pain during discography

The reproduction of pain is the single most important factor in determining whether a subsequent intervention on a disc will be successful in reducing discomfort. If the test does not reproduce or elicit any pain during injection, it indicates that the disc is not likely the cause; this may also be true in the instance of a herniated disc or if the disc has a fissure. In this event, other diagnostic interventions may be considered.