Diffuse Disc Bulge

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Published: June 9, 2017
Last reviewed: June 15, 2017

This article explains the term diffuse disc bulge commonly found on the reports of magnetic resonance (MR) and computed tomography (CT) images of the spine.

What is the spinal disc?

The spinal or intervertebral discs are cartilages between the bones (vertebra) in the spine (Picture 1).

Spinal or intervertebral disc

Picture 1. A normal spinal or intervertebral disc

What is a disc bulge?

A disc bulge is a condition in which at least 25% (90°) of the disc’s circumference extends beyond its normal limits and the soft disc center does not break out through the outer fibrous ring (Picture 2[1].

Disc bulge - CT image

Picture 2. A CT image of a disc bulge (blue) (source: Radiopaedia, CC license)

What is a diffuse disc bulge?

The term diffuse disc bulge has no specific meaning but just describes a disc bulge in general. However, some doctors may use it instead of a broad-based herniation.

A disc bulge rarely causes any symptoms while a disc herniation can put pressure on the spinal nerve roots and cause pain in the neck, back, arm or leg. If your magnetic resonance (MR) or computed tomography (CT) image report mentions a diffuse disc bulge and it is not clear what it means, ask your doctor.

Details about the causes, symptoms, treatment and prevention of a bulging and herniated disc.

What is a diffuse annular bulge?

A diffuse annular disc bulge is just a long term for a disc bulge but some doctors use it when they want to emphasize that only the outer part of the disc called annulus fibrosus is involved in the bulge and there is no herniation.

What is a minimal or mild diffuse disc bulge?

In a minimal or mild disc bulge, the disc extends only slightly beyond its normal limits and rarely causes any problems.

What is a circumferential diffuse disc bulge?

A circumferential diffuse disc bulge extends over 50-100% of the disc’s circumference [1]. Note, that the severity of the symptoms tends to decrease with the percent of the disc’s circumference involved.

What is a posterior and posterolateral diffuse disc bulge?

A posterior or central diffuse disc bulge points backward to the spinal cord [1].

A posterolateral diffuse disc bulge points backward and laterally to the right or left spinal nerve root and may cause pain in an arm or leg.

What does the diffuse disc bulge L4-L5 or L5-S1 mean?

  • The disc L4-L5 is the one between the 4th and 5th lumbar vertebra in the lower back.
  • The disc L5-S1 is the one between the 5th lumbar and 1st sacral vertebra in the lower back.

If one of these discs bulges out, it may, rarely, cause pain in the lower back, buttock or leg.

 

  • References

      1. Fardon DF et al, 2014, 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  The Spine Journal

5 Responses to Diffuse Disc Bulge

  1. Teresa Poindexter says:

    MRI SPINE LUMBAR WO CONTRAST – DetailsPrinter friendly page–New window will open
    About This Test
    Details
    Study Result
    Impression
    IMPRESSION:

    Lumbar spine degenerative changes are predominated by facet arthropathy at L4-L5 and mild bulging of the discs at L3-L4 and L4-L5.

    Lumbar spine degenerative findings are as fully detailed above, without evidence of significant canal stenosis or exiting nerve root compression at any level.

    VOICE DICTATED BY: Dr. Stetson Bickley
    Narrative
    EXAMINATION: MRI LUMBAR SPINE 9/1/2017 2:45 PM

    ACCESSION NUMBER: 113280922

    INDICATION: MRI Lumbar eval radiculopathy Pain across the lower back goes into left hip

    COMPARISON: Lumbar spine x-rays 7/26/2017 lumbar spine MRI 10/1/2010

    TECHNIQUE: Multisequence, multiplanar MR images were obtained of the lumbar spine without the administration of intravenous contrast.

    FINDINGS: There are 5 lumbar vertebral bodies with vertebral body numbering performed with the designation of the last well formed intervertebral disc as L5-S1.

    Vertebral body heights are preserved. Chronic type degenerative endplate changes of the anterior superior corner of L3 L3, anterior superior corner of L4, and anterior superior corner of L5. Probable lipid poor hemangioma at L3.

    Level specific findings:

    T12-L1: No significant canal or foraminal stenosis.

    L1-L2: No significant degenerative change, neuroforaminal narrowing, or spinal canal stenosis.

    L2-L3: No significant degenerative change, neuroforaminal narrowing, or spinal canal stenosis.

    L3-L4: Minimal disc bulge. No significant canal or foraminal stenosis.

    L4-L5: Mild bilateral facet arthropathy. Circumferential disc bulge. No significant canal or foraminal stenosis.

    L5-S1: No significant degenerative change, neuroforaminal narrowing, or spinal canal stenosis.

    The visualized portions of the distal spinal cord are of normal caliber and signal characteristics.. The conus medullaris terminates at the L1 level. The cauda equina is unremarkable.

    Left renal cortical T2 hyperintensity is incompletely characterized but is probably a cyst.
    What does all this mean. I am having terrible pain in my lower back.

    • Jan Modric says:

      In short: there is no pinched nerves and only two discs are mildly bulged. There are some changes in “facet joints,” which are joints on each side of the vertebra that connect vertebra with each other.

      So, your pain might be due to “facet arthropathy,” which usually results from “wear and tear” of the spine.

      You also seem to have a cyst in your left kidney.

  2. ADITYA GAUTAM says:

    Straightning of lumber spine.
    Disc decsiccation at L5 S1 level.
    Mild disk bulge at L4 L5 level indicating thetical sac.
    Diffuse disc bulged at L5 S1

    • Jan Modric says:

      These descriptions say that two discs (L4-L5 and L5-S1) are bulging out, but it does not say that they would pinch any nerve, so it is not sure if they cause pain.

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