Imaging in the diagnostics of low back pain
Journal Title: Medycyna Ogólna i Nauki o Zdrowiu - Year 2010, Vol 16, Issue 2
Abstract
Diagnostic work-up of low back pain (LBP) is often characterized by overimaging. Abundance of information retrieved from images may sometimes be misleading and result in diagnostic pitfalls. The purpose of this review is to describe sensitivity and specificity of most often prescribed non-invasive imaging studies – plain radiography (PL) (static and dynamic), computed tomography (CT), magnetic resonance imaging (MRI) and bone scyntygraphy (BS). PL is sensitive and specific as a diagnostic tool in cases of advanced deformities related to ankylosing spondylitis, selected congenital and developmental malformations, but lack appropriate sensititvity in detecting early stages of tumor or infection. Due to low specificity PL is of limited value in diagnostics of spondylo-atrhrotic cause of LBP in older patients. Dynamic radiography is crucial in diagnostics of spinal instabilities. CT is useful in diagnostics of lumbar stenosis, as well as disc extrusion; however abnormalities may be detected in asymptomatic individuals. MRI is sensitive in diagnostics of tumor, infection, and disc pathologies; however, significant rate of asymptomatic disc deformities is reported. MRI is sensitive in the detectionof tumors and foci of infection, and is characterised by high sensitivity with respect to intervertebral disc pathology, nevertheless a positive result is observed among a considerable percentage of people without LBP. BS is helpful in detection of regions of increased bone metabolism, but lacks cause specificity. Some authors recommend BS in children suspected of organic cause of LBP.Each referral for imaging examination in the case of LBP should be preceded by a thorough patient examination and the analysis of the role of the information anticipated in the diagnostictherapeutic process. The image description is not a diagnosis and does not seem to be useful and appropriate information for the patient.
Authors and Affiliations
Marek Krasuski, Piotr Tederko
Keywords
Related Articles
- EP ID EP69687
- DOI -
- Views 117
- Downloads 0
Nutrition during pregnancy
introduction and objective of the study: The feotus derives all the necessary components from the mother, which is why in pregnant women a balanced diet should provide the right amount of energy, and also contain essenti...
Assessment of knowledge of the principles of provision of first aid among drivers
[b][/b]introduction. Car accidents and resulting injuries are among the major causes of deaths. In Poland, there are four times as many fatal accidents as in other countries of the European Union. Very often, accidents a...
Period of employment, occupational burnout and stress coping strategies among midwives
introduction. The work of midwives is associated with incurring psychological costs which is very often the factor that causes stress. Perceived level of work-related stress may lead to the development of occupational bu...
The role of nurses in the care of ophthalmologic patients – an example of problems in patients with glaucoma, before and after trabeculectomy
Introduction: One of the main causes of blindness is glaucoma, a disease that each year deprives millions of people of their sight. Currently, the world is inhabited by over 7 million people who, because of glaucoma, ir...
Hyperkalemia – how to protect your patient? Case report
Hyperkalemia is a side effect which is often observed in clinical practice. Knowledge of the causes and symptoms of hyperkalemia is extremely important due to the fact that hyperkalemia may be life-threatening. The risk...