Diagnostic criteria for the clinical syndrome of internal disc disruption: are they reliable?

A new disease, named internal disc disruption (IDD), has provoked debate. Some insist that discography is specific for the diagnosis, while others disagree. Without scientific verification, some doctors have performed invasive operations for this uncertain disease. It is necessary to explore the diagnostic criteria and characteristics of IDD. We investigated the background, history, diagnostic methods and criteria of IDD by a review of the literature. The criteria for diagnosis of IDD are diverse. The minimum requirements for the diagnosis were the pattern of pain and the shape on discography. Although the pain pattern is important for the correct diagnosis, it depends on the subjective report of the patient. The diagnosis is up to the patient, and the examiner alone cannot make it. We conclude that IDD is not a real, but a hypothetical disease. Until scientific verification is forthcoming any invasive procedures should be restricted.