Objectives: the objective of this document is to agree which diagnostic procedures should be used in some common clinical situations within the chronic low back pain spectra to reduce the variability of clinical practice, to adapt technologies to the pathologies and to reduce the health care risks Methodology: using a modified RAND technique two groups of professionals (specialists in diagnostic imaging and clinical) have been asked to rank the appropriate use of seven technologies in six different clinical conditions. The average group puntuacuions have been presented twice to the group to assess whether there was convergence to a consensus point. Results were evaluated, and statistical differences between groups were checked. A panel of specialists consensuated the final consensus priority setting list. Results: in uncomplicated low back pain and without alarm signs, no imaging test is needed. In other situations, the simple radiograph or alternativement magnetic resonance are the tests of choice; clinical judice is left to the radiologist to decide on the need of contrast. Radiculomielography, Computed Tomography, and scintigraphy have a role much more residual low-back pain. Conclusions: when facing a patient with low-back pain, despite the numerous tests available, simple radiography and magnetic resonance imaging are sufficient to perform the majority of appropriated diagnostic tests.
Chronic low back pain; Diagnosis; Diagnostic Imaging
Solà-Morales O, Galimany J. Lumbàlgia crònica: utilització apropiada de les proves de diagnòstic per la imatge. Barcelona: Agència d’Informació, Avaluació i Qualitat en Salut; 2010.
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