Predictive Validity of Lumbar X-ray Images and MRIs for Chronic Low Back Pain Subtypes
Journal Title: Journal of Pain & Relief - Year 2019, Vol 7, Issue 3
Abstract
Purpose: The aim of this observational study alongside our inter-rater reliability trial (ISRCTN 43417727) is to investigate the accuracy of lumbar X-ray images and MRIs as diagnostic tools of low back pain (LBP) subtypes (sacroiliac joint, disc and facet joint). Patients and methods: Included were patients aged 18 or more with medical history and physical examination suggestive of a chronic LBP subtype, followed by a diagnostic test block. Numbers of spinal imaging tests, and whether or not pathology was present was evaluated in patients with positive- as well as negative diagnostic test blocks. The sensitivity, specificity, positive and negative predictive value of the lumbar X-ray images and MRIs discriminating between the three LBP subtypes are presented. Results: One hundred patients were included. Facet joint pain was a general working diagnosis in 40 patients, disc pain in 8 patients and SI joint pain in 35 patients. The positive predictive value of X-ray was 82.6% for facet joint pain, 66.7% for disc pain and 60% for SI joint pain; the negative predictive value of X-ray was 50% for facet joint pain, 66.7% for disc pain and 7.7% for SI joint pain. The positive predictive value of MRI was 81.8% for facet joint pain, 50% for disc pain and 0% for SI joint pain; the negative predictive value of MRI was 55.6% for facet joint pain, 0% for disc pain and 13% for SI joint pain. Conclusion: The predictive validity of lumbar X-ray images and MRIs to distinguish between low back pain subtypes in patients with chronic LBP is questionable.
Authors and Affiliations
Cornelis Wilhelmus Jacobus Van Tilburg, Johannes George Groeneweg, Dirk Leendert Stronks, Frank Johannes Petrus Maria Huygen
Keywords
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- DOI 10.4172/2167-0846.1000321
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