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Therapeutics
Rapid magnetic resonance of the lumbar spine was not better than radiographs for evaluating low back pain

https://doi.org/10.1136/ebm.9.1.19

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    Jarvik JG, Hollingworth W, Martin B, et al. Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial. JAMA 2003;289:2810–8.
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 Q In patients with low back pain (LBP), are there clinical or economic consequences when replacing lumbar spine radiography (LSR) with rapid magnetic resonance imaging (MRI)?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Rheumatology ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    randomised controlled trial with 12 months of follow up.

    Embedded ImageAllocation:

    concealed.*

    Embedded ImageBlinding:

    blinded (outcome assessors.)*

    Embedded ImageFollow up period:

    12 months.

    Embedded ImageSetting:

    4 imaging centres in Western Washington State, USA.

    Embedded ImagePatients:

    380 patients >18 years of age (mean age 53 y, 56% women) who had LBP with or without radiating leg pain referred for radiographs of their lumbar spine. Exclusion criteria included lumbar surgery within 1 year before enrolment, history of acute external trauma, metallic implants in the lumbar spine, any contraindications for MRI, lack of a telephone, pregnancy, and inability to speak English.

    Embedded ImageIntervention:

    190 patients each …

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    Footnotes

    • ↵* See glossary.

    • For correspondence: Dr J G Jarvik, University of Washington, Seattle, WA, USA. jarvikju.washington.edu

    • Sources of funding: Agency for Healthcare Research and Quality and National Institute for Arthritis and Musculoskeletal and Skin Diseases.

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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2004; 9 32-32 Published Online First: 18 Feb 2004. doi: 10.1136/ebm.9.1.32