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Low Back Pain and MRI'S - Part II

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As a follow-up to Low Back Pain and MRI’s Part I, here is an example of low back symptoms not correlating with imaging findings. This is from Flynn’s article (1). This is the case of a 62 year-old man, showing significant “pathology” on his Xray and MRI. Notice on his Xray, the large bone spur on the left. This Xray shows degenerative disc disease at several levels and poor alignment at the top of his lumbar spine. His MRI shows a herniated disc at L2-L3 and severe spinal stenosis. This man manages his intermittent symptoms with exercise, yoga and occasional physical therapy. He enjoys an active lifestyle, including hiking and canoeing.

1. Flynn TW, Smith B, Chou R. Appropriate use of diagnostic imaging in low back pain: A reminder that unnecessary imaging may do as much harm as good. Journal of Orthopaedic & Sports Physical Therapy. 2011; 41:838-846.

Matt Seltzer