Choosing Wisely:

Don’t obtain imaging (plain radiographs, MRI, CT, or other advanced imaging) of the spine in patients with non-specific acute low back pain and without red flags.

Rationale and Comments: Imaging of the spine in patients with acute low back pain during the early phase of symptom onset is unnecessary. Red flags that may indicate that early imaging of the spine is required can include neurological deficit such as weakness or numbness, any bowel or bladder dysfunction, fever, history of cancer, history of intravenous drug use, immunosuppression, steroid use, history of osteoporosis, or worsening symptoms.
Sponsoring Organizations:
  • American Association of Neurological Surgeons and Congress of Neurological Surgeons
  • Sources:
  • Systematic review
  • Disciplines:
  • Orthopedic
  • References: • Chou R, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478–91.

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