Over-imaging in uncomplicated low back pain: a 12-month audit of a general medical unit

Intern Med J. 2016 Dec;46(12):1437-1439. doi: 10.1111/imj.13279.

Abstract

Low back pain is frequently encountered in hospitals and is a leading cause of disability, often involving costly imaging that exposes a patient to radiation. A retrospective 12-month audit at a South Australian tertiary hospital aimed to evaluate the frequency, modality and appropriateness of imaging in patients with low back pain. Results showed that the general medical unit was unnecessarily ordering imaging in 40% of patients who exhibited no indications warranting such a procedure. A standardised protocol is required to preventing clinicians from requesting imaging solely for the purposes of self-reassurance, patient reassurance or fear of litigation.

Keywords: back pain; general medicine; imaging; indication; radiation.

MeSH terms

  • Aged
  • Clinical Audit*
  • Cost-Benefit Analysis
  • Decision Making
  • Humans
  • Low Back Pain / diagnostic imaging*
  • Low Back Pain / etiology
  • Low Back Pain / pathology
  • Magnetic Resonance Imaging* / adverse effects
  • Magnetic Resonance Imaging* / economics
  • Magnetic Resonance Imaging* / statistics & numerical data
  • Middle Aged
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Radiation Exposure / adverse effects
  • Radiation Exposure / prevention & control*
  • Retrospective Studies
  • South Australia / epidemiology
  • Unnecessary Procedures / economics
  • Unnecessary Procedures / statistics & numerical data*