On January 31, 2011 - immediate Imaging x-ray, CT scan or MRI of patients with acute low back pain is advised for all patients, according to new guidelines by the American College of Physicians.
The guidelines, which appear in the issue of February 1 of the Annals of Internal Medicine, suggest that these Imaging tests are appropriate for people with low back pain which may be due to cancer, infection, nerve damage or pain worsens despite initial treatment.
Signs of more serious conditions include loss of weight, the fever, muscular strength loss, and/or sensation in the legs and abnormal reflexes in addition to low back pain.
"Needless to Imaging exposes patients to preventable harms, can cause other unnecessary interventions and results unnecessary charges,"concluded researchers led by Roger Chou, MD, Oregon Health and Science University in Portland.""
Chou and colleagues reviewed the literature on the use of reviews of routine in individuals with low back pain Imaging. Basically, patients with an acute back pain without results suggesting a specific underlying State had the same result with or without these tests. Some tests, such as x-ray, require radiation and a low risk of exposure to radiation.
Daniel M. Walz, M.D., Chief of the division of the musculo-skeletal Imaging at University Hospital, North Shore in Manhasset, New York, bed materials spinal cord MRI per day. He tells WebMD that the new guidelines was correct.
"Each patient feels that their record is not complete without MRI", he said. "These places of imagery is so present in the community that patients feel really they should get, but it does not change".
There are some cases where MRI or other imaging procedures are justified, he said. "If someone has a history of cancer, and there is reason to suspect that the cancer has spread to the spine, or there is nerve damage, I would suggest an MRI to help determine whether or not surgery is necessary".
At a certain age, almost everyone a findings on MRI, Walz said. "Sometimes see us too much and Imaging is not correlated with the back pain, so this leads us where we are pursuing the things that we should not be pursuing this route."
For example, it may consider protuberant rear disc on MRI in many patients without back pain. A previous study showed that 90% of people 60 years or older have a degenerate or bulging disk. "A patient hears that they have discs domed and said: 'You need to fix'", he said.
"Before you insist on MRI, see someone who specializes in the diagnosis and treatment of back pain," he said.
Andrew Haig, MD, Professor of physical medicine and rehabilitation at the University of Michigan in Ann Arbor, explains this simple step - see pain in the back, as a Physiatrist - specialist can help reduce unnecessary Imaging tests and subsequent surgery of the spine in as much as one-third.
The new guidelines suggest other tests if the low back pain worsens or persists despite a trial of therapy.
Richard j. Herzog, MD, a radiologist dealing with at the hospital for special surgery in New York, said: "If the pain persists, you would then appropriate imaging studies to determine appropriate therapies."
"Yes, imagery is overallocated, but highest of patients is educated, these tests will be ordered in an appropriate manner," said.
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