Original Title: Uso de la radiografía en el diagnóstico de la lumbalgia: revisión sistemática

Authors' objectives: Determine criteria for appropriate use of radiography in the diagnosis of low back pain, in order to contribute to a reduction in variability of clinical practice, reduce risks to patient health and make rational use of health resources.

Authors' results and conclusions: The literature search identified 25 studies with relevant information about the use of x-ray in diagnosing low back pain, of which 14 corresponded to Clinical Practice Guidelines and 11 to Systematic Reviews. Following a fulltext review of the available studies, nine Clinical Practice Guidelines and seven Systematic Reviews were included, on the basis of their high methodological quality. The available evidence indicates that in patients with acute, non-specific low back pain without red flags, lumbar spine x-ray is not justified, due to its limited diagnostic validity. Radiography is indicated when the symptoms are indicative of cancer, ankylosing spondylitis, vertebral fracture or spinal infection. Conclusions Routine imaging studies are not recommended in patients with non-specific low back pain without red flags. Radiography is indicated based on suspicion of serious underlying disease. The main indications for lumbosacral radiography are: suspected vertebral fracture, suspected cancer, suspected ankylosing spondylitis or suspected infection.

Authors' methods: A systematic review of the scientific literature was conducted, comprising a literature search focused on identifying systematic reviews, clinical trials, observational studies, clinical practice guidelines and evaluation reports in a variety of biomedical databases. The search covered publications from 2006 to December 2013, that evaluate the use of radiography as a diagnostic test in adult patients with non-specific low back pain. A secondary review was conducted, on the bibliographies of the identified articles. A critical reading was carried out on the selected items, in order to identify any methodological problems that might affect their validity.

Project Status: Completed

Year Published: 2014

URL for published report: https://www.ogasun.ejgv.euskadi.eus/r51-catpub/es/k75aWebPublicacionesWar/k75aObtenerPublicacionDigitalServlet?R01HNoPortal=true&N_LIBR=051591&N_EDIC=0001&C_IDIOM=es&FORMATO=.pdf

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government