Here at Central Ohio Spine and Joint, there are questions that we get asked almost daily within our clinic, one of which is do we take x-rays. In an effort to be evidence-based and patient-centered, we continue to follow up to date evaluation and treatment protocols. Current guidelines state imaging should only be performed when needed, not routinely.
So the question is when is it needed? If you have been a patient of ours in the past you understand how our evaluation process goes. We perform a thorough consultation and a comprehensive evaluation. As a physician it is our job to develop a working diagnosis from that consultation and evaluation. For the vast majority of cases we can derive this conclusion without imaging. In the case where we identify “Red Flags” imaging is appropriate. Red flags can be defined by the following:
-Severe or progressive neurologic deficits (e.g., bowel or bladder function, saddle parasthesia)
-Sudden back pain with spinal tenderness (especially with history of osteoporosis, cancer, steroid use)
-Serious underlying medical condition (e.g., cancer)
In the absence of red flags, treatment is usually initiated. In following the current treatment guidelines, if a patient fails to respond appropriately within 2-4 weeks, at that point imaging is recommend. We conservatively image around 15% of the people that consult our office.
Want more information on what to expect from our office? Check out What to Expect As a New Patient.