About One in Three in ED for Low Back Pain Receive Imaging

Imaging is obtained for about one in three patients with emergency department visits for low back pain, according to a study published online in the American Journal of Roentgenology.

Jina Pakpoor, M.D., from the Hospital of the University of Pennsylvania in Philadelphia, and colleagues examined the use of imaging for patients with emergency visits for low back pain. Current Procedural Terminology codes were used to identify imaging modalities. Data were included for 134,624 encounters.

The researchers found that imaging was obtained in 33.7 percent of patients who visited the emergency department for low back pain. The use of imaging in the emergency department for the initial evaluation of low back pain decreased from 34.4 percent in 2011 to 31.9 percent in 2016 (odds ratio, 0.98 per year). During the study period, 30.9, 2.7, and 0.8 percent of patients underwent radiography, computed tomography, and magnetic resonance imaging, respectively, for evaluation of low back pain. There was significant variation noted in the use of imaging by geographic region; compared with patients in the western United States, those in the southern United States underwent 10 percent more imaging.

"Although there has been a modest decline, in 2016, approximately one in three patients still continued to receive imaging in the emergency department," the authors write. "Additional research is needed to understand the underlying reasons for persistent use of potentially unwarranted imaging in the emergency setting."

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