scholarly journals JUSTIFICATION OF RADIOLOGICAL PROCEDURES ALGORITHM ADJUSTMENT IN DIAGNOSIS OF LOWER BACK PAIN CAUSE AT UNIVERSITY CLINICAL CENTER TUZLA

2019 ◽  
Vol 49 (1) ◽  
Author(s):  
Aida Denjagić
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Radiation Dose ◽  
Lower Back Pain ◽  
Lower Back ◽  
Clinical Center ◽  
Spine Ct ◽  
Diagnostic Key ◽  
Magnetic Resonance Imaging Mri ◽  
Radiological Procedures

Introduction: Lower Back Pain (LBP) is one of the most frequent reasons for visiting physican. Authors of guidelines scrutinizing use of radiography and Computed tomography (CT) or Magnetic resonance imaging (MRI) in LBP diagnostic. Method of choice in the LBP diagnostic should be MRI except in cases where we should get diagnostic informations as soon as possible (traumas etc.) and in strict indications in bone structures where CT should be a method of choice. Increase of CT use and following icrease CT derived radiation dose in patients are very serious problems of last decades. Aim: To show the nessesary of procedure algorithm adjusment in LBP diagnostic. Reasons are: danger of overdiagnosis leading to chronifications, loosing time and money to get exact diagnose and leading to cumulate very high ionizing doses (10 mSv per person with average body weight from lumbar spine CT) that could couse a cancer if it is over 100 mSv (in some studies if it is over 50 mSv).  Patients and methods: Sixty-nine patients, average age of 51.35 years, were included in the study. Lumbar spine CT was performed and repeated procedure at MRI in a very short time in Clinic for Radiology and Nuclear Medicine of University Clinical Centre Tuzla from January 1 2017 to February 9 2018. The sample of patients was formed consecutively. Referral diagnosis for CT procedures were: M51 in 36 patients (52.17%), N/A in 13 (18.84%), M05 in 4 (5.8%), G83.4 in 3 (4.35%) and other in 13 (18.84%). Results: 30 (83.33%) of patients were referred from CT to MRI procedure in time under 42 days (during acute phase). Relation of justified and unjustified undertaken CT procedures were: 71% unjustified, 10% justified and 19% N/A.Conclusion: Performed study showed unjustified undertaken CT procedures and high unnecessary radiation dose in 71% patients. There are justified reasons for procedure algorithm adjusment in LBP diagnostic. Key words: lower back pain, diagnostic procedure algorithm, CT, MRI

scholarly journals Combined Lumbar Spine MRI and CT Appropriateness Checklist: A Quality Improvement Project in Saskatchewan, Canada

2021 ◽  
Author(s):  
Maryam Madani Larijani ◽  
Amir Azizian ◽  
Tracey Carr ◽  
Scott J Adams ◽  
Gary Groot
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Lower Back Pain ◽  
Evidence Based ◽  
Health Region ◽  
Lower Back ◽  
Spine Ct ◽  
Imaging Appropriateness ◽  
Pain Patients ◽  
Spine Mri

Abstract Background As rates of advanced imaging for lower back pain continue to increase, there is a need to ensure appropriateness of imaging. The goal of this project was to reduce the number of inappropriate MRI and CT requests for lower back pain patients and facilitate appropriate imaging by developing a combined imaging appropriateness checklist for lumbar spine MRI and CT. Methods In prior work, we developed and adopted individual evidence-based lumbar spine MRI and CT checklists into the radiology requisition process. In the current project, a combined checklist was developed and trialed in one of the former Saskatchewan health regions (Five Hills) beginning in May 2018. Using statistical process control (SPC), control charts compared monthly number of imaging requests pre- and post-checklist implementation from May 2017 to February 2020. Monthly number of lumbar spine MRI and CT requisitions in the nearby former Saskatchewan Regina Qu’Appelle Health Region, in which the combined checklist was not trialed, were also plotted and compared as a balancing measure. Results In Five Hills, a shift (decrease) was observed in the monthly number of lumbar spine MRI requisitions seven months following the implementation of the combined checklist. However, the monthly number of lumbar spine CT requisitions did not change significantly. In the Regina Qu’Appelle Health Region, there was a shift (increase) in the monthly number of lumbar spine MRI requisitions, while the monthly number of lumbar spine CT requests decreased after the implementation of the combined checklist. Conclusions The combined checklist with evidence-based indications for lumbar spine MRI and CT imaging in lower back pain patients appeared to reduce the complexity associated with two previous individual checklists and facilitate imaging appropriateness. Accountable benefits may include the reduction of radiation exposure as a result of unnecessary and repeated imaging and reduction in wait times for CT and/or MRI.

A Comparative Roentgenographic Analysis of the Lumbar Spine in Male Army Recruits with and without Lower Back Pain

2003 ◽  
Vol 58 (12) ◽  
pp. 985-989 ◽  
Author(s):  
E.L Steinberg ◽  
E Luger ◽  
R Arbel ◽  
A Menachem ◽  
S Dekel
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Lower Back Pain ◽  
Lower Back ◽  
Army Recruits

scholarly journals Lower back pain with sciatic disorder following L5 dermatome caused by herpes zoster infection

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Roslind Karolina Hackenberg ◽  
Arnd Von den Driesch ◽  
Dietmar Pierre König
Keyword(s):  
Back Pain ◽  
Herpes Zoster ◽  
Lower Back Pain ◽  
Pain Treatment ◽  
Acute Onset ◽  
Mri Scan ◽  
Lower Back ◽  
Acyclovir Treatment ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

We report the case of a 62-year-old patient with lower back pain radiating into the right leg accompanied by numbness. The pain had an acute onset and was resistant to conservative pain treatment. A magnetic resonance imaging (MRI) scan of the lumbar spine showed no degenerative discovertebral lesions, but a swelling of the nerve root supplying the affected dermatome. For pain treatment the patient received lumbar epidural infiltrations. During this treatment the patient suddenly developed a skin rash with grouped vesicular blisters on an erythematous ground. After the diagnosis of a lumbar herpes zoster and an acyclovir treatment, the patient could be discharged in an ameliorated condition. This case demonstrates the importance to consider rare causes of lumbosciatic pain and disorders and to acknowledge unspecific changes in a MRI scan.

Frequency of potential causes of lower back pain and incidental findings in patients with suspected sacroiliitis: retrospective analysis of 886 patients with negative sacroiliac MRI examination for sacroiliitis

2020 ◽  
pp. 028418512096856
Author(s):  
Hasan Emin Kaya ◽  
Ülkü Kerimoğlu
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Incidental Findings ◽  
Uterine Fibroids ◽  
Mri Imaging ◽  
Imaging Studies ◽  
Lower Back ◽  
Lumbosacral Transitional Vertebra ◽  
Sacral Insufficiency Fractures ◽  
Magnetic Resonance Imaging Mri

Background In a majority of patients with suspected sacroiliitis (SI) who underwent sacroiliac magnetic resonance imaging (MRI), imaging studies may be normal, may depict other causes for pain, or may show clinically irrelevant incidental findings. Purpose To determine the prevalence of possible etiologies other than SI and frequency of incidental findings demonstrated on sacroiliac MRI examinations in a cohort of patients with lower back pain and suspected SI. Material and Methods Sacroiliac MRI examinations of 1421 patients with suspected SI were retrospectively reviewed. In patients without SI findings, other potential causes for lower back pain and incidental findings were documented. Results SI was present in 535 of 1421 patients (37.6%). In 886 of the patients whose MRI studies were negative for SI, other possible causes for lower back pain or incidental findings were seen in 386 (43.5%). The most common musculoskeletal (MSK) finding was lumbosacral transitional vertebra (8.6%) followed by findings suggesting piriformis syndrome (4.2%), spondylosis (3.7%), and sacral insufficiency fractures (1.8%). The most common non-MSK findings were follicular cysts (15.3%) and uterine fibroids (4.9%). Conclusion In patients with suspected SI but negative MRI examinations for SI, some other possible causes for lower back pain and several incidental findings can be seen on imaging. The presence of these findings may explain the patient’s symptoms, and awareness of these conditions may be helpful in patient management and individualizing treatment.

scholarly journals PECULIARITIES OF AUTONOMIC NERVOUS SYSTEM STATE IN YOUNG PATIENTS WITH NEUROLOGICAL MANIFESTATIONS OF LUMBAR SPINE OSTEOCHONDROSIS

2021 ◽  
Vol 21 (2) ◽  
pp. 71-76
Author(s):  
I.I. Krychun ◽  
N.V. Vasylieva ◽  
F. Chadid
Keyword(s):  
Nervous System ◽  
Back Pain ◽  
Autonomic Nervous System ◽  
Lumbar Spine ◽  
Lower Back Pain ◽  
Anxiety And Depression ◽  
Neurological Manifestations ◽  
Autonomic Nervous ◽  
Lower Back ◽  
Depression Level

Lower back pain is the most common cause forcing adults to seek for medical assistance; it is associated with severe functional disorders and burdens on patients themselves and health care system that require in-depth study of its causes, management, and prevention. The aim of this research is to investigate the peculiarities of autonomic nervous system status depending on indices (rates) of anxiety and depression in patients under 45 years with lower back pain and to develop more effective treatment. We examined 104 male patients with neurological manifestations of the lumbar spine osteochondrosis without obesity, somatic and cardiovascular pathology (average age was 34,05±5,7 years) and 25 practically healthy volunteers (the mean age constituted 35,04±3,6). All patients were shared into two groups. The 1st group consisted of 50 patients with radiculopathy caused by herniation of intervertebral discs, whereas the 2nd group involved 54 patients who suffered from radicular signs of lumbar spine osteochondrosis. The patients underwent clinical (somatic) and neurological examinations, thorough assessment of the autonomic nervous system, psychological states by Hospital Anxiety and Depression Scale (HADS) in addition. We have revealed that the muscular-tonic disorders with myofascial syndrome occurred in all patients. We also found a reliable increase in the expression of vegetative complaints and symptoms in comparison with the control group. Analysis of anxiety and depression indices by HADS has reflected that average anxiety level in control group amounted to 8.33±1.24 scores and the depression level made up 0,8±1,06 scores; in the patients with vertebrogenic radiculopathy, the average anxiety level constituted 9.78±1.58 scores and the depression level was assessed as 4.1±2.13 scores. The patients suffering from reflexogenic lower back pain had the anxiety level, which equalled 8.01±1.16 scores and the depression level of 1.53±1.5 scores. Severe muscular-tonic signs and the development of vegetative dystonia syndrome in association with subclinical increasing levels of anxiety in spite of unchanged depression rates have been found as key features of neurological manifestations of the lumbar spine osteochondrosis in young male patients.

scholarly journals Effect of Different Physiotherapy Programs on Pain and Functional State of the Torso in Individuals with Chronic Non-Specific Lower Back Pain

2019 ◽  
Vol 1 (18) ◽  
Author(s):  
Erika Prišmontaitė ◽  
Saulė Sipavičienė
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Functional State ◽  
Lower Back Pain ◽  
Functional Disability ◽  
Labour Productivity ◽  
Nordic Walking ◽  
Lower Back ◽  
Spine Mobility ◽  
Walking Group

Research background. In the modern society, lower back pain is the most widespread health disorder with negative economic consequences for healthcare costs and labour productivity. According to the epidemiological research, lower back pain is ranked 6th out of 291 diseases and conditions, that cause the highest rate worldwide of incapacity to work. The aim of the research was to establish the effect of different physoiotherapy methods on pain, torso functional of people with chronic non-specifc lower back pain. Methods. Forty patients were included in the study. Subjects were divided into control and three experimental groups: back-stabilization exercises group; physiotherapy in water group; Nordic walking group. We measured intensity of lower back pain, functional state of the torso, mobility of lumbar spine, active movements amplitudes and the static endurance of the torso. Results. It was found that all the analysed parameters statistically significantly (p < 0.05) improved in all examined groups. While assessing the results of the investigated groups interdependently, it was determined that the parameters such as: the intensity of the pain, the functional state and the mobility of the torso, statistically signifcantly (p < 0.05) improved more effectively in the physiotherapy in water and back-stabilization exercise groups in comparison with the Nordic walking group. Conclusions. Physiotherapy procedures in water and back-stabilization exercises decreased the intensity of the pain and functional disability, improved the lumbar spine mobility and active movements amplitudes, more efciently than the programme of Nordic walking, for people with chronic non-specifc lower back pain. However, all three types of exercises equally increased the static endurance of the torso.Keywords: chronic non-specifc lower back pain, spinal stabilization exercises, physiotherapy in water, Nordic walking.

scholarly journals Relief of Lower Back and Leg Pain after Myelography

2016 ◽  
Vol 10 (1) ◽  
pp. 539-542
Author(s):  
Rui Guo ◽  
Toshihiko Sakakibara ◽  
Tetsutaro Mizuno ◽  
Koji Akeda ◽  
Tetsushi Kondo ◽  
...  
Keyword(s):  
Back Pain ◽  
Intermittent Claudication ◽  
Lower Back Pain ◽  
Adverse Reactions ◽  
Leg Pain ◽  
Mri Findings ◽  
Spinal Disorder ◽  
Lower Back ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal

Introduction: It is well-known that many patients will have adverse reactions such as headache and nausea after undergoing myelography, but we have often seen cases where symptoms such as lower back pain and leg pain were alleviated following myelography. To the best of our knowledge, such clinical cases of post-myelographic alleviation have not been reported. Materials and Methods: A total of 325 patients with a degenerative lumbar spinal disorder who underwent myelography were prospectively investigated at four hospitals from April 2012 to March 2014 to survey the post-myelographic alleviation of lower back and leg pain prospectively. The severities of lower back pain, leg pain and numbness of the lower extremities were evaluated and intermittent claudication distance was measured before myelography. The magnetic resonance imaging (MRI) findings and myelographic findings were also evaluated for the patients that their symptoms were improved. Results: Thirty-five of 325 cases (10.8%) of these patients had their symptoms alleviated after undergoing myelography; 26 cases of lower back pain, two cases of leg pain, two cases of numbness of the lower extremity, and five cases of intermittent claudication. Conclusion: In the patients of a degenerative lumbar spinal disorder, about 10% cases with lower back pain or intermittent claudication had post-myelographic alleviation. Intradural injection therapy might be a therapeutic method to alleviate these symptoms.

scholarly journals Algorithm of Radiological Diagnostics of Dystrophic Damage to Ligaments of the Lumbosacral Spine in the Lower Back Pain Syndrome: the Potential of Sonography

2018 ◽  
pp. 109-114
Author(s):  
A. N. Mihailov ◽  
A. M. Yurkovskiy ◽  
I. V. Nazarenko
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Structural Changes ◽  
Clinical Manifestations ◽  
Diagnostic Errors ◽  
Diagnostic Algorithm ◽  
Pain Syndrome ◽  
Lumbosacral Spine ◽  
Lower Back ◽  
Magnetic Resonance Imaging Mri

Objective: to formulate the main points of the diagnostic algorithm in the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments based on the limits and potential of visualization methods. Material. Data of X-ray, multispiral computer tomography (MSCT), magnetic resonance imaging (MRI) and sonography of 184 patients aged 19-79 with clinical manifestations of the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments were analyzed. Results. The potential of the visualization methods in the assessment of structural changes of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments has been identified. The main points of the algorithm which makes it possible to diagnose the lower back pain syndrome, caused by pathology of ilio-lumbar, posterior long sacroiliac and sacrotuberal ligaments have been formulated. Conclusion. The choice of the visualization method in the lower back pain syndrome, caused by ligamentosis of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments must be made taking into account the limits and potential of MSCT, MRI and sonography, which will shorten the time of diagnostic search and reduce the risk of diagnostic errors.

Sign in / Sign up

Export Citation Format

Share Document