Through its ability to make relatively noninvasive and repeatable measurements, MRI has a great deal to offer, not only to clinical diagnosis of intervertebral disc disorders but also as a tool for basic research into disc physiology and the etiology of disc degeneration. In this brief review we outline the structure of the disc, the composition and organization of its macromolecules, and the changes that occur during disc degeneration, attempting to summarize features that have been or could become targets of MRI characterization. It is important to recognize, however, the fundamental limitation that most of the changes so far observed in MRI are consequences of alterations in cellular metabolism that occurred months to years previously and provide little insight into the current functional status of the tissue. There is therefore a need to develop MR techniques that directly characterize cellular activity and factors such as nutrient delivery on which it is critically dependent. We therefore briefly review cellular energy metabolism and nutrient transport into the avascular disc and consider the ability of MRI to reveal information about such processes. As a corollary of this discussion we also consider the constraints that the unusual transport properties of the disc impose on the delivery of contrast agents to the disc, since an understanding of these limitations is central to interpretation of the resulting images. MOST MRI INVESTIGATIONS of the spine are currently undertaken in an effort to establish the causes of back pain. However, the links between back pain and degeneration of the intervertebral disc are still, like most conditions involving congenital or acquired abnormalities of the disc, surprisingly poorly understood. This unsatisfactory situation reflects, in large part, our poor understanding of the physiology of the normal disc, and in particular, the relationships between function, or malfunction, and structure at the cellular and molecular levels. The requisite information is difficult to acquire due, largely, to experimental difficulties of various sorts. The intervertebral disc is closely coupled structurally, physiologically, and biomechanically, to the vertebral body and surrounding ligaments and musculature. The value of many measurements on excised discs in vitro is therefore severely compromised because these relationships are inevitably disrupted. In vivo approaches are also limited. Because these measurements generally involve extensive interventions, they have generally been confined to animals, but there is great variability in disc structure between species and few animals show degenerative changes resembling those in the human. Through its ability to make relatively noninvasive and repeatable measurements, MRI may here have a great deal to offer, not only to clinical diagnosis, but also as a tool for basic research (1).In this brief review we initially summarize the structure of the disc, the composition and organization of its macromolecules, and the changes that occur during dis...