To X-ray or Not To X-Ray?

Chris Lorang The Research, Your Best Life Leave a Comment

Imaging does not always help us in treatment of our patient’s pain.

One question that we often hear from prospective new patients is “Do you take X-rays?”

We do not routinely order X-rays, and, in fact, we don’t even have an X-ray machine. If after an examination an X-ray, MRI, or CT (imaging) is deemed clinically necessary, we will order these tests from an outside imaging center.

Most patients are relieved to learn we don’t default to taking X-rays, as they hope to limit their exposure to radiation as well as their costs. Our clinic’s policy on imaging is based on several key pieces of research.

Click on the statements below to learn more about each subject and why we choose to be very conservative with our use of imaging.

Capital Chiropractic’s clinical approach is based on current pain management research and patient outcomes. We order X-rays and MRIs only when clinically necessary. If at any time we suspect that it is in the best interest of your health, we won’t hesitate to send you to an imaging center for additional testing.

Learn more about our evidence-based treatments for pain management such as joint manipulation, soft tissue and massage treatments, acupuncture, the McKenzie Method and active rehabilitation exercises, click here.

As always, we are in pursuit of your best life!

To schedule an appointment: Call 515-421-4018 or email office@capitalchirodsm.com.

Citations

  1. Chou R, Qaseem A, Snow V, Casey D, Cross JT, Shekelle P, et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491. doi: 10.7326/0003-4819-147-7-200710020-00006
  2. Defined as: “Acute, subacute, or chronic uncomplicated low back pain or radiculopathy. No red flags. No prior management.”
  3. Appropriateness Criteria, American College of Radiology.
  4. Jarvik JG, Gold LS, Comstock BA, Heagerty PJ, Rundell SD, Turner JA, Avins AL, Bauer Z, Bresnahan BW, Friedly JL, James K, Kessler L, Nedeljkovic SS, Nerenz DR, Shi X, Sullivan SD, Chan L, Schwalb JM, Deyo RA. Association of Early Imaging for Back Pain With Clinical Outcomes in Older Adults. JAMA. 2015;313(11):1143-1153. doi:10.1001/jama.2015.1871
  5. U.S. Food and Drug Administration – Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging
  6. Brinjikji, et al., Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A417
  7. Carragee, Eugene et al. Are first-time episodes of serious LBP associated with new MRI findings? The Spine Journal , Volume 6 , Issue 6 , 624 – 635
  8. Brinjikji, et al., Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A417
  9. Weiner BK, Patel R. The accuracy of MRI in the detection of Lumbar Disc Containment. Journal of Orthopaedic Surgery and Research. 2008;3:46. doi:10.1186/1749-799X-3-46.
  10. Tsai K-J, Chiang H, Jiang C-C. Magnetic resonance imaging of anterior cruciate ligament rupture. BMC Musculoskeletal Disorders. 2004;5:21. doi:10.1186/1471-2474-5-21.

Image Credits – Radiopaedia:

Normal Lumbar Spine Xray – Case courtesy of Dr Craig Hacking

Normal Lumbar Spine MRI – Case courtesy of A.Prof Frank Gaillard

Normal Cervical Spine Xray – Case courtesy of Dr. Andrew Dixon

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