Magnetic resonance imaging and radio-graphic findings in chronic low back pain.A clinicoradiological correlational study

Abstract

Background: Chronic Low Back Pain (LBP) commonly referred to as Lumbago is one of the most common causes for consultations in outpatient clinics and specialized orthopaedic departments. Although the differential diagnosis of LBP is broad, the majority of patients seen in primary care will have nonspecific LBP. In most cases, radiology plays a key role in identifying the cause and thereby assisting in clinical decision making. Plain radiography and MRI are the main imaging modalities used in LBP. MRI is expensive and not readily affordable to most of the Kenyan public. The purpose of this study was to develop an imaging protocol that categorized which patients were most likely to benefit from MRI imaging to enable judicious utilization of imaging in a resource poor setting. Aim: The aim of the study was to evaluate the findings of Plain radiography and MRI in relation to the clinical presentation of patients presenting with Chronic Low Back Pain so as to ascertain which category of patients are most likely to benefit from imaging. Methodology: A cross sectional study was carried out at two diagnostic imaging centres in Nairobi: Kenyatta National Hospital (KNH) and Plaza Imaging Solutions. Study population: Patients referred for Lumbosacral radiographs and Spine MRI examination were consecutively recruited into the study following informed consent over a period of 4months between September and December 2014. Patients’ clinical presentation and imaging findings were documented in a data collection sheet, correlated and analysed using STATA. Results:A total of 180 patients comprising of 53(29.4%) males and 127(70.6%) females were enrolled into the study. The mean age was 47.3years (SD=14.5 Years).The mean BMI among the patients was 26.3 (SD=26.3). Majority of the patients worked in an office setting (48%), 38.5% worked as domestic workers (housewives/unemployed), 10% had manual jobs and the rest (3.4%) were students.