Choosing Wisely:

Don’t order an imaging study for back pain without performing a thorough physical examination.

Rationale and Comments: A thorough history and physical examination are necessary to guide imaging decisions. Ordering spine imaging without obtaining a history and physical examination has not been shown to improve patient outcomes and increases costs.
Sponsoring Organizations:
  • American Academy of Physical Medicine and Rehabilitation
  • Sources:
  • Cochrane Database of Systematic Reviews
  • Disciplines:
  • Orthopedic
  • References: • Chou R, Qaseem A, Owens DK, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med. 2011 Feb 1;154(3):181–9.

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