Low back pain: an assessment using positional MRI and MDT.

Area of Science:

• Orthopedics
• Radiology
• Biomedical Engineering

Background:

• Current guidelines recommend against routine imaging for low back pain.
• Positional MRI offers enhanced assessment of the lumbar spine in functionally loaded positions.
• This case report highlights the utility of positional MRI in evaluating low back pain.

Observation:

• A patient with low back pain underwent Mechanical Diagnosis and Therapy (MDT) assessment and positional MRI.
• MDT assessment classified the patient as 'other' due to conflicting subjective and objective findings.
• Positional MRI was performed in flexed, upright, and extended sitting postures.

Findings:

• Positional MRI confirmed MDT assessment findings.
• A dynamic spinal stenosis was identified.
• The spinal stenosis reduced in flexion and increased in extension, correlating with patient symptoms.

Implications:

• Positional MRI can aid in the assessment and classification of complex low back pain cases.
• This imaging modality may reveal dynamic pathologies not evident on standard MRI.
• Findings suggest positional MRI could refine diagnosis and treatment strategies for specific low back pain presentations.