ASSOCIATION BETWEEN CLINICAL LEG PAIN CHARACTERISTICS AND LUMBAR MAGNETIC RESONANCE IMAGING FINDINGS IN PATIENTS WITH SCIATICA: A CROSS-SECTIONAL STUDY

Abstract

Background: Sciatica is a common cause of radiating leg pain, most often resulting from lumbosacral nerve root irritation. Although magnetic resonance imaging (MRI) is routinely used to evaluate lumbar spine pathology, the association between clinical presentation and MRI findings remains uncertain.

Objective: This study assessed lumbar MRI findings and their association with clinically reported leg pain characteristics in patients with sciatica.

Methods: This descriptive cross-sectional study was conducted at Mardan Medical Complex, Pakistan, from January to April 2026. A total of 126 patients aged 18–65 years with clinically suspected sciatica who underwent lumbar spine MRI were enrolled using convenience sampling. Clinical data included the side and dermatomal distribution of leg pain. MRI variables comprised the level and side of disc involvement, disc pathology type, and nerve root compression. Associations were assessed using the Chi-square test, with p<0.05 considered statistically significant.

Results: The mean age of participants was 43 ± 13 years, and 54.0% were male. Right-sided leg pain (64.3%) and L4 dermatomal involvement (63.5%) were the most frequent clinical findings. Disc bulging (76.2%) was the predominant MRI abnormality, and the L5–S1 level was most commonly involved (39.7%). Right-sided disc involvement was observed in 77.0% of patients. A significant association was found between the side of leg pain and the side of lumbar disc involvement (p=0.001). No significant associations were observed between the side of leg pain and the level of disc involvement (p=0.08), disc pathology type (p=0.30), or nerve root compression (p=0.70).

Conclusion: Disc bulging and L5–S1 involvement were the predominant MRI findings in patients with sciatica. The side of leg pain correlated significantly with the side of lumbar disc involvement but not with the level of disc involvement, disc pathology type, or nerve root compression, highlighting the importance of integrating clinical assessment with MRI findings.