Diagnostic imaging for back pain.
BACKGROUND
X-rays and computerised tomography (CT) scans for back pain are often ordered to exclude pathology, to make a positive diagnosis and/or as a response to patient expectations.


OBJECTIVE
This article reviews the evidence about the accuracy of diagnostic imaging to allow rational ordering without compromising patient satisfaction.


CONCLUSIONS
X-rays make no difference to outcomes for back pain and related disability. For the exclusion of serious causes of back pain, the accuracy of X-rays and CT scans is limited. Most positive findings on radiological investigations, particularly degenerative findings, have little or no association with back pain. A history that includes the key features of serious causes will detect all patients requiring imaging. Care is required in explaining results of radiological investigations to patients to reassure about the absence of serious causes and to put incidental findings into perspective.
Yelland
Michael
M
Centre for General Practice, University of Queensland. myelland@bigpond.com
D001416:Back Pain / Q000000981:diagnostic imaging / Q000209:etiology*; D003937:Diagnosis, Differential; D005194:Family Practice / Q000379:methods*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D010817:Physician-Patient Relations; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed