Generally, imaging is not used during the first 6 weeks of acute back pain as long as the following conditions are met:
• no other neurologic signs or symptoms
• no trauma
• no history of malignant tumour
• patient’s age is between 18 and 50.
(Strayer 2006)
• no other neurologic signs or symptoms
• no trauma
• no history of malignant tumour
• patient’s age is between 18 and 50.
(Strayer 2006)
X-RAY
X-ray is an inexpensive and noninvasive imaging method that is able to reveal general changes of arthritis and bony alignment. Some disadvantages of x-ray are that it only shows bony structures and the patient is exposed to radiation (Strayer 2006).
COMPUTED TOMOGRAPHY
Computed tomography (CT) scan may be used in patients who cannot undergo magnetic resonance imaging (MRI) evaluation or as an adjunct to MRI. The CT scan is less sensitive to changes in the soft tissues of the spine than MRI. However, a CT scan is able to show the bony elements of the spine, as well as discs, nerves, and ligaments. Contrast agents may be used in CT scanning to highlight masses and abnormal fluid/tissue collections (Strayer 2006).
MAGNETIC RESONANCE IMAGING
Magnetic resonance imaging (MRI) utilizes strong magnetic fields and radio frequencies to provide information on all tissues of the spine. MRI is superior to CT for evaluation of soft tissue structures. Contrast agents may be used to highlight masses, epidural scarring as a result of previous surgeries and abnormal tissue/fluid collections. MRI cannot be used in patients with metallic implants or pacemaker (Strayer 2006).
BONE SCAN
In a bone scan, radioactive tracers are injected into the patient. These tracers attach themselves to areas of increased bone production or increased vascularity associated with tumour or infection. Bone scan is often use to evaluate and assess for occult fractures, suspected bony metastasis or spondylolysis, a destructive lesion of the vertebra (Strayer 2006).