Differential diagnosis of severe back pain using MRI.

Back pain, despite its prevalence, often presents a diagnostic dilemma. Infection, degeneration, and neoplasm comprise major etiologic categories of severe nonspecific back pain. Diagnostic evaluation includes plain roentgenograms, computerized tomography, and radionuclide studies, all of which are often equivocal or misleading. We retrospectively analyzed 21 presentations of severe back pain of various causes evaluated by magnetic resonance imaging (MRI) in addition to conventional diagnostic imaging modes. A characteristic MRI pattern of both the lesions's distribution and its signal intensity was observed that delineated each etiologic category. MRI was found to be particularly suited for use in the differential diagnosis of nonspecific back pain.