Annular fissure L5/S1

Case contributed by Laughlin Dawes


Low back pain

Patient Data

Age: 50 years
Gender: Female

L5/S1 disc desiccation with radial annular fissure.

Case Discussion

Degenerative disc changes are associated with the development of annular fissures (also known as 'annular tears' although the use of the term 'tear' is now discouraged as the presence of this finding does not necessarily indicate a traumatic cause). Annular fissures involve either part or the entire thickness of the annulus. They run perpendicular to the long axis of the annulus and occur more commonly in the posterior half of the discs, usually at L4-5 and L5-S1. The radial annular tear is considered by many to be responsible for pain.

MRI shows focal areas of high signal on T2WI or on contrast-enhanced T1WI. On T2 sagittal images, radial tears appear as globular or horizontal lines of high signal within the posterior annulus.

Credit: Dr Ahmed Haroun.

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