title: Prevalence of spinal pathology in patients presenting for lumbar MRI as referred from general practice.
abstract: BACKGROUND
  The use of magnetic resonance imaging (MRI) as initial imaging for back pain has increased in general practice. However, few data are available on the characteristics of these referred patients. The objective of this study was to describe the baseline characteristics and MRI findings of patients presenting for a lumbar MRI examination as referred by their GP.
  
  
  METHODS
  Patients presenting for a lumbar MRI examination as referred by their GP were recruited at the MRI Center. The MRI radiology reports were scored for the presence of disc bulging, disc herniation, nerve root compression, spinal stenosis, spondylolisthesis and serious pathologies. Information on patients' characteristics, characteristics of the complaints and red flags were derived from questionnaires. Cross-sectional differences between patients with and without specific MRI findings were analyzed.
  
  
  RESULTS
  A total of 683 low back pain (LBP) patients were included; mean age was 49.9 (range 19-80) years and 53% was male. Mean back pain severity score was 6.6 (SD 2.0) and 67% of the patients reported having chronic LBP. In total, 374 patients (55%) reported sciatica complaints for at least 6 weeks. Of all MRI reports, 69% mentioned signs of nerve root compression. Serious pathologies were reported in 3% of the patients. In total, 94% of patients had abnormal MRI findings.
  
  
  CONCLUSIONS
  Almost all patients presenting for a lumbar MRI examination as referred by their GP had abnormal MRI findings. In total, 55% of the patients reported persistent sciatica in which imaging is recommended according to international guidelines.
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, e.deschepper@erasmusmc.nl.
authors.forename: Evelien I T
authors.initials: EI
authors.lastname: de Schepper
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam.
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.affiliation: MRI Center, Amsterdam.
authors.forename: Erik F H
authors.initials: EF
authors.lastname: Veldhuizen
authors.affiliation: Department of Radiology and.
authors.forename: Edwin H G
authors.initials: EH
authors.lastname: Oei
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, Department of Orthopaedics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam.
authors.forename: Pim A J
authors.initials: PA
authors.lastname: Luijsterburg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000453:epidemiology*; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011843:Radiculopathy / Q000175:diagnosis / Q000453:epidemiology*; D012017:Referral and Consultation; D012585:Sciatica / Q000175:diagnosis / Q000453:epidemiology; D013122:Spinal Diseases / Q000175:diagnosis / Q000453:epidemiology; D013130:Spinal Stenosis / Q000175:diagnosis / Q000453:epidemiology*; D013168:Spondylolisthesis / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
keywords: Back pain; musculoskeletal/connective tissue disorders; pain; primary care; radiology.