The use of diagnostic imaging in low back or leg pain

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.

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.

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.

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.