The use of diagnostic imaging in low back or leg pain

Gokce Kutsal, F. Yesim; Karahan, Sevilay; YAMAN, Ayşegül

The use of diagnostic imaging in low back or leg pain

Ayşegül YAMAN, (Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey)

Yeşim Gökçe KUTSAL, (Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey)

Sevilay KARAHAN (Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey)

Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi

3 0

Yıl: 2017 Cilt: 63 Sayı: 4 Sayfa Aralığı: 313 - 317 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

The use of diagnostic imaging in low back or leg pain

Öz:

Objectives: The aim of this study is to evaluate the imaging method preferences of physicians working in different clinics and departments for the patients suffering from low back and/or leg pain.Patients and methods: In this retrospective study, the radiological imaging types of 900 patients (301 males, 599 females; mean age 46.8±17.1 years; range 2 to 89 years) with low back and/or radicular leg pain who were admitted for the first time to the Physical Medicine and Rehabilitation (PMR), Orthopedics and Traumatology (OT), and Neurosurgery (NS) clinics in our hospital between July 2013 and August 2014 were reviewed. Age, sex, and radiological methods applied were recorded. The correlation between radiological methods and differences in terms of age and sex and how the radiological method preferences differed according to the departments were evaluated.Results: Of the patients, 22%, 35% and 34.7% were evaluated without using any imaging methods in the OT, PMR, and NS outpatient clinics, respectively. A total of 32.7%, 48.7%, and 8.7% of the patients were evaluated using lumbar X-ray in the OT, PMR, and NS outpatient clinics, respectively. A total of 19.3%, 11.7%, and 54.3% of the patients were evaluated using the lumbar magnetic resonance imaging (MRI) in the OT, PMR, and NS outpatient clinics, respectively. There were no statistically significant correlations between the age, sex, and imaging modality used.Conclusion: Our study results showed that the most common imaging tool which is used by the physicians in the PMR and OT clinics is lumbar X-ray, while the lumbar MRI is the most common tool in the NS clinics. However, we recommend that not only the medical, but ethical aspects and cost-effectiveness of the imaging modality to be selected should be considered.

Anahtar Kelime:

Konular: Rehabilitasyon

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol 2010;24:769-81.
2. Cassidy JD, Carroll LJ, Côté P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976) 1998;23:1860-6.
3. Centers for Disease Control and Prevention. National Ambulatory Medical Care Survey: 2010 Summary Tables. Available from: http://www.cdc.gov/nchs/data/ ahcd/namcs_summary/2010_namcs_web_tables.pdf. [Accessed on: September 30, 2014]
4. Erçalık C, Tuncer T. Epidemiology of mechanical low back pain. Turkiye Klinikleri J PM&R-Special Topics 2011;4:1-5.
5. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012;64:2028-37.
6. van Tulder M, Becker A, Bekkering T, Breen A, del Real MT, Hutchinson A, et al. Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 2006;15:169-91.
7. Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med 2007;147:478-91.
8. Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet 2009;373:463-72.
9. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 1994;331:69-73.
10. Bradley WG. ACR Appropriateness Criteria Low Back Pain. AJNR Am J Neuroradiol 2007;28:990-2.
11. Motiei-Langroudi R, Sadeghian H, Seddighi AS. Clinical and magnetic resonance imaging factors which may predict the need for surgery in lumbar disc herniation. Asian Spine J 2014;8:446-52.
12. Flynn TW, Smith B, Chou R. Appropriate use of diagnostic imaging in low back pain: a reminder that unnecessary imaging may do as much harm as good. J Orthop Sports Phys Ther 2011;41:838-46.
13. Atalabi OM, Ogunlade SO, Agunloye AM. The lumbosacral radiographs in the initial screening of low back pain - is one view enough? Niger J Clin Pract 2011;14:284-6.
14. Keshtkaran A, Bagheri MH, Ostovar R, Salari H, Farokhi MR, Esfandiari A, et al. Developing Criteria for Lumbar Spine Magnetic Resonance Imaging (MRI) Using RAND Appropriateness Method (RAM). Iran J Radiol 2012;9:130-8.
15. Jame SZ, Sari AA, Majdzadeh R, Rashidian A, Arab M, Rahmani H. The extent of inappropriate use of magnetic resonance imaging in low back pain and its contributory factors. Int J Prev Med 2014;5:1029-36.
16. Lehnert BE, Bree RL. Analysis of appropriateness of outpatient CT and MRI referred from primary care clinics at an academic medical center: how critical is the need for improved decision support? J Am Coll Radiol 2010;7:192-7.
17. Lateef H, Patel D. What is the role of imaging in acute low back pain? Curr Rev Musculoskelet Med 2009;2:69-73.
18. Chou R, Qaseem A, Owens DK, Shekelle P. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med 2011;154:181-9.
19. Patel ND, Broderick DF, Burns J, Deshmukh TK, Fries IB, Harvey HB, et al. ACR Appropriateness Criteria Low Back Pain. J Am Coll Radiol 2016;13:1069-78.

APA	YAMAN A, Gokce Kutsal F, Karahan S (2017). The use of diagnostic imaging in low back or leg pain. , 313 - 317.
Chicago	YAMAN Ayşegül,Gokce Kutsal F. Yesim,Karahan Sevilay The use of diagnostic imaging in low back or leg pain. (2017): 313 - 317.
MLA	YAMAN Ayşegül,Gokce Kutsal F. Yesim,Karahan Sevilay The use of diagnostic imaging in low back or leg pain. , 2017, ss.313 - 317.
AMA	YAMAN A,Gokce Kutsal F,Karahan S The use of diagnostic imaging in low back or leg pain. . 2017; 313 - 317.
Vancouver	YAMAN A,Gokce Kutsal F,Karahan S The use of diagnostic imaging in low back or leg pain. . 2017; 313 - 317.
IEEE	YAMAN A,Gokce Kutsal F,Karahan S "The use of diagnostic imaging in low back or leg pain." , ss.313 - 317, 2017.
ISNAD	YAMAN, Ayşegül vd. "The use of diagnostic imaging in low back or leg pain". (2017), 313-317.

APA	YAMAN A, Gokce Kutsal F, Karahan S (2017). The use of diagnostic imaging in low back or leg pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 63(4), 313 - 317.
Chicago	YAMAN Ayşegül,Gokce Kutsal F. Yesim,Karahan Sevilay The use of diagnostic imaging in low back or leg pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 63, no.4 (2017): 313 - 317.
MLA	YAMAN Ayşegül,Gokce Kutsal F. Yesim,Karahan Sevilay The use of diagnostic imaging in low back or leg pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, vol.63, no.4, 2017, ss.313 - 317.
AMA	YAMAN A,Gokce Kutsal F,Karahan S The use of diagnostic imaging in low back or leg pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2017; 63(4): 313 - 317.
Vancouver	YAMAN A,Gokce Kutsal F,Karahan S The use of diagnostic imaging in low back or leg pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2017; 63(4): 313 - 317.
IEEE	YAMAN A,Gokce Kutsal F,Karahan S "The use of diagnostic imaging in low back or leg pain." Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 63, ss.313 - 317, 2017.
ISNAD	YAMAN, Ayşegül vd. "The use of diagnostic imaging in low back or leg pain". Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 63/4 (2017), 313-317.