| T O P I C R E V I E W |
| mala |
Posted - 12/12/2004 : 23:24:44
Hi all
Here is some more information about the usefulness (or should I say uselessness) of xrays in determining causes of back pain. It's taken from the Scientic American.
- "Radiological investigations reveal little useful information."
This week we continue with the article by Dr. Richard Deyo published in the august 1998 edition of Scientific American.
Physicians send patients with low back pain to often for radiological investigations.
For patients less than 50 years old who pass a good physical exam, x-rays reveals usefull information in only 1 case out of 2500. The practice of standard x-rays for patients is pointless.
Epidemiological studies indicate the same percentage of radiological abnormalites in the normal population than in the population of low back pain sufferers. Therefore in the vast majority of cases the cause of low back pain cannot be determined by an x-ray.
The interpretation of the same x-ray by different radiologists can give different reports. Deciding treatment based on a x-ray result may lead to poor treatment choices.
An x-ray of the low back exposes the genitals of patients to signifcant dose of radiation, about 1000 times stronger than a x-ray of the lungs. This is not insignificant.
The problem has not been solved with the advent of new technologies. A study revealed that 20% of people under 60 years of age ( persons never suffering low back pain) had a herniated disc present on a MRI (Magnetic Reasonance Imaging) exam. In a group of none back pain sufferers over 60 years of age, 35% have a herniated disc, 80% a disc protrusion and 20% spinal stenosis.
These studies clearly show that the patients' condition and not the test result most dictate treatment. A radiological exam is useful only when it confirms something discovered on a physical examination. More and more physicians use these tests only when a surgical intervention is being considered.
So much for believing the doctor who tells you that your pain is from a herniated disk or protusion.
Another study by Michael N Brant-Zawadzki of Hoag Memorial Hospital in Newport Beach Calif., revealed that about two thirds of the pain free individuals chosen for this study had abnormal disks. Detecting a herniated disk on an imaging test therefore proves only one thing conclusively: the patient has a herniated disc.
Good Luck & Good Health
Mala |
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