Radiologists utilize imaging studies to accurately diagnose a variety of causes of low
back pain. In primary care, the most commonly used imaging modalities are X-ray, MRI, CT, and
nuclear medicine bone scan. Sometimes, more advanced imaging techniques are used in
anticipation for surgery and that includes CT myelography and PET scans.
By having specialized training with these techniques radiologists are able to provide
assistance to surgeons and other medical practitioners. X-rays are helpful for evaluation of
fracture, bony deformity including degenerative changes, sacroiliitis, disk and vertebral body
height, and assessment of bony density and architecture. MRI or CT is recommended in
patients with severe or progressive neurologic deficits or with serious underlying conditions,
such as vertebral infection, cauda equine syndrome, or cancer with spinal cord compression.
MRI does not require radiation exposure and provides better visualization of soft tissue and
spinal canal, and thus preferred over CT. Computed tomography (CT) has superior depiction of
cortical bone than MRI. It may be better in visualizing fractures and detecting facet
degenerative changes. Bone scans are used mainly to detect occult fractures, stress fractures,
infections, or bony metastases and to differentiate them from degenerative changes.
Radiologists can take patient findings and correlate them with the appropriate imaging
studies to provide diagnoses, further diagnostic studies if needed, and possibly a treatment
Author 1: Braden Stoeger UWSP Biology Major
Author 2: Kunal Patel, MD
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