Rapid Magnetic Resonance Imaging vs Radiographs for Patients With Low Back Pain

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Abstract
Advances in magnetic resonance imaging (MRI) have led to faster and therefore less expensive examinations. Several groups, including ours, have reported the development of a rapid MRI examination for the lumbar spine.1-6 Using rapid MRI early in the care of patients with low back pain might benefit patients by providing a swifter definitive diagnosis, obviating further imaging or referral, and reassuring both patient and physician that there is no serious disease. However, early imaging with rapid MRI risks discovering incidental anatomic findings. In studies of subjects without low back pain, disk herniations are seen in approximately one third,7-10 disk bulges in half to two thirds,7,8,10,11 and disk degeneration in up to 90% of the scars.7,10,11 Identifying incidental abnormalities with early MRI might lead to unnecessary interventions that otherwise would not have been performed, potentially resulting in both worse patient outcomes and higher costs.
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