ArticleEClinicalMedicine2023
Low back pain of disc, sacroiliac joint, or facet joint origin: a diagnostic accuracy systematic review.
Article in EClinicalMedicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Effectiveness of single-photon emission computed tomography (SPECT/SPECT-CT) in predicting therapeutic response to facet interventions for facet joint-related low back pain: A systematic review and Meta-Analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Pooled it
- Consensus practice guidelines on sacroiliac joint complex pain from a multispecialty, international working group.Pain medicine (Malden, Mass.) · 2025Guideline
- Supplemental nucleus pulposus allograft in patients with lumbar discogenic pain: results of a prospective feasibility study.BMC musculoskeletal disorders · 2025Trial
- Efficacy of a Tumor Necrosis Factor Inhibitor in Chronic Low-Back Pain With Modic Type 1 Changes: A Randomized Controlled Trial.Arthritis & rheumatology (Hoboken, N.J.) · 2025Trial
- Association Between Diagnostic Imaging, Medication Intake, and Health Outcomes in Chronic Whiplash-Associated Disorders: An Observational Study.Physiotherapy Canada. Physiotherapie Canada · 2026Article
- Pathophysiology, diagnosis, and management of discogenic low back pain: a phenotype-driven precision framework for surgical and interventional decision-making.Frontiers in surgery · 2026Review
- Diagnostic evidence in suspected discogenic low back pain: a pain-source attribution perspective.Frontiers in medicine · 2026Review
- Direct pars repair techniques for lumbar spondylolysis: a comparative literature review.Turkish journal of medical sciences · 2026Review
- A mechanistic hypothesis: osteopathic manipulative therapy may modulate immune cell function in chronic low back pain.Frontiers in pain research (Lausanne, Switzerland) · 2026Article
- Central and peripheral factors moderating pain effects on motor control and disability in chronic lumbosacral radicular pain.Journal of neuroengineering and rehabilitation · 2025Article
- Identifying S3 and S2 as Key Pain-Sensitive Targets in High-Frequency Ultrasound Therapy for Sacroiliitis.Journal of clinical medicine · 2025Article
- Targeting Ferroptosis With Ginsenoside Rg3 Alleviates Intervertebral Disc Degeneration.Orthopaedic surgery · 2025Article
- 14. Discogenic Low Back Pain.Pain practice : the official journal of World Institute of Pain · 2025Review
- Comprehensive Analysis of Chronic Low Back Pain: Morphological and Functional Impairments, Physical Activity Patterns, and Epidemiology in a German Population-Based Cross-Sectional Study.Bioengineering (Basel, Switzerland) · 2025Article
- NJournal of orthopaedic translation · 2025Review
- Article
- Exercises for the prevention of non-specific low back pain.The Cochrane database of systematic reviews · 2024Article
- Bacterial growth in patients with low back pain and Modic changes: protocol of a multicentre, case-control biopsy study.BMJ open · 2024Article
- The clinical significance of the Neutrophil-to-Lymphocyte Ratio as a novel inflammatory biomarker for assessing the severity of intervertebral disc degeneration.Frontiers in medicine · 2024Article
- Associations between Degenerative Lumbar Scoliosis Structures and Pain Distribution in Adults with Chronic Low Back Pain.Healthcare (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The accuracy of diagnostic tests available in primary care to identify the disc, sacroiliac joint, and facet joint as the source of low back pain is uncertain. Methods: Systematic review of diagnostic tests available in primary care. MEDLINE, CINAHL, and EMBASE were searched between March 2006 and 25th January 2023. Pairs of reviewers independently screened all studies, extracted data, and assessed risk of bias using QUADAS-2. Pooling was performed for homogenous studies. Positive likelihood ratios (+LR) ≥2 and negative likelihood ratios (-LR) ≤0.5 were considered informative. This review is registered with PROSPERO (CRD42020169828). Findings: We included 62 studies: 35 investigated the disc, 14 the facet joint, 11 the sacroiliac joint, and 2 investigated all three structures in patients with persistent low back pain. For risk of bias, the domain 'reference standard' scored worst, however approximately half the studies were of low risk of bias for every other domain. For the disc, pooling demonstrated MRI findings of disc degeneration and annular fissure resulted in informative +LRs: 2.53 (95% CI: 1.57-4.07) and 2.88 (95% CI: 2.02-4.10) and -LRs: 0.15 (95% CI: 0.09-0.24) and 0.24 (95% CI: 0.10-0.55) respectively. Pooled results for Modic type 1, Modic type 2, and HIZ on MRI, and centralisation phenomenon yielded informative +LRs: 10.00 (95% CI: 4.20-23.82), 8.03 (95% CI: 3.23-19.97), 3.10 (95% CI: 2.27-4.25), and 3.06 (95% CI: 1.44-6.50) respectively, but uninformative -LRs: 0.84 (95% CI: 0.74-0.96), 0.88 (95% CI: 0.80-0.96), 0.61 (95% CI: 0.48-0.77), and 0.66 (95% CI: 0.52-0.84) respectively. For the facet joint, pooling demonstrated facet joint uptake on SPECT resulted in informative +LRs: 2.80 (95% CI: 1.82-4.31) and -LRs: 0.44 (95% CI: 0.25-0.77). For the sacroiliac joint, a combination of pain provocation tests and absence of midline low back pain resulted in informative +LRs of 2.41 (95% CI: 1.89-3.07) and 2.44 (95% CI: 1.50-3.98) and -LRs of 0.35 (95% CI: 0.12-1.01) and 0.31 (95% CI: 0.21-0.47) respectively. Radionuclide imaging yielded an informative +LR 7.33 (95% CI: 1.42-37.80) but an uninformative -LR 0.74 (95% CI: 0.41-1.34). Interpretation: There are informative diagnostic tests for the disc, sacroiliac joint, and facet joint (only one test). The evidence suggests a diagnosis may be possible for some patients with low back pain, potentially guiding targeted and specific treatment approaches. Funding: There was no funding for this study.
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