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Carphology by A Fo Ben

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Unnecessary imaging for back pain

The temptation to image the lumbar spine in patients with low back pain (but without features suggesting a serious underlying condition) should be resisted, according to a recent meta-analysis (1804 patients in six studies). Short- and long-term clinical outcomes were no different in patients with acute or subacute low back pain undergoing lumbar imaging compared with those receiving usual clinical care. The results were most applicable to patients investigated in a primary care setting.

Lancet 2009;373:463–72.

CT angiography radiation risk

CT angiography is regarded as relatively non-invasive but the radiation exposure is not trivial. In a multicentre study of 1965 patients undergoing CT angiography in a cardiac setting, the median “dose-length product” (DLP) was 885 mGy × cm, corresponding to a radiation dose 12 mSv (equivalent to 600 chest x rays). There was a worrying variability …

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