Use of lumbosacral spine radiographs in a level II emergency department.

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Abstract
We studied indications for lumbosacral spine radiographs in an emergency department setting.Clinicians completed a lumbosacral spine request form before obtaining lumbosacral radiographs on 482 patients who were examined in a level II emergency department. The clinicians detailed the indications for the examination, their suspected clinical diagnoses, and the expected effect of the lumbosacral spine study on management. In addition, the duration of the patients' symptoms was recorded as well as their age and sex. These data were compared with the actual radiographic findings as interpreted by board-certified musculoskeletal radiologists.Major indications for lumbosacral radiographs were lower back pain (92%) and trauma (36%). Patient expectation and medicolegal concerns, related either to insurance documentation or to physician litigation, were cited in 42% of cases. A neurologic deficit was present in 88% of patients, and a history of neoplasm was elicited in 4%. Strain (56%) and fracture (20%) were the ...

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