Rapid MR imaging versus plain radiography in patients with low back pain: initial results of a randomized study.
OBJECTIVE
To demonstrate the feasibility of a randomized trial to compare rapid magnetic resonance (MR) imaging with plain radiography as the initial imaging study in patients with low back pain, to test measures of the decision-making process and patient outcomes, and to offer a model for using randomized clinical trials to evaluate diagnostic tests.


METHODS
The authors randomly selected 62 patients with low back pain to undergo either rapid MR imaging or plain radiography. The authors measured functional status, satisfaction, and general health status at baseline and at 3 months. The modified Roland scale was the primary outcome measure. In addition, the authors examined diagnostic and therapeutic decision making and resources used by each group.


RESULTS
There were no statistically significant differences between the two patient groups with respect to outcome (Roland score: MR imaging = 12.5, radiography = 12.1). MR imaging provided more useful information to clinicians and resulted in greater patient reassurance.


CONCLUSIONS
Randomly selecting patients to undergo imaging examinations and measuring outcomes is feasible; however, a larger, multicenter study is necessary to determine whether rapid MR imaging is a cost-effective replacement for plain radiography in patients with low back pain.
Jarvik
J G
JG
Department of Radiology, School of Medicine, University of Washington, Seattle 98195, USA.
Maravilla
K R
KR
Haynor
D R
DR
Levitz
M
M
Deyo
R A
RA
D000328:Adult; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011859:Radiography; D013997:Time Factors