The correlation between large-amplitude lower hybrid waves and density depletions, termed spikelets, lower hybrid cavities, or lower hybrid solitary structures has been attributed to the change in the refractive index computed from the homogeneous plasma dispersion relation. However, the appropriate refractive index includes the electron Hall term involving the density gradient. We demonstrate that the Hall term produces ray trajectories which are profoundly different from the homogeneous plasma dispersion relation.