Imaging of low back pain in a public health centre : a study of test request behaviour of doctors

Abstract

Background Lumbosacral spine radiography is a proven and valuable procedure for evaluating the vertebrae, disk spaces, facet and uncovertebral joints, neural foramina and paravertebral soft tissues. The purpose of radiographic examinations is to identify or exclude anatomic abnormalities or disease processes of the spine and related tissues. The written or electronic requests should provide the necessary information to show the medical need for the examination and allow for its appropriate performance and interpretation. Objective Our study was conducted to evaluate the appropriateness of lumbar spine radiography requests for low back pain in a public health centre. The benchmarks used were the 2009 NICE guidelines on the management of persistent non-specific low back pain and the 2011 Royal College of Radiologists’ referral guidance. Method A descriptive, retrospective, cross-sectional study design was applied. A random sample of 100 lumbosacral spine radiographs was analyzed as recommended by the Royal College of Radiologists guideline tool and the 2009 NICE guidelines. Data was obtained from the Radiology Information System (RIS) and the Picture Archiving and Communication System (PACS). Results Sixty-four percent (n=64) of lumbar radiographs performed for low back pain were indicated and judged as appropriate as per existing guidelines. One radiograph (1%) was performed for non-specific low back pain. Conclusion This study reached its objectives of evaluating the appropriateness of lumbar spine radiography requests for low back pain. It was noted that there is a need to increase awareness of the Royal College of Radiologists guidelines to enhance appropriate use of lumbosacral spine radiography to ensure more efficient resource utilisation