Lumbar MR imaging and reporting epidemiology: do epidemiologic data in reports affect clinical management?

Radiology. 2012 Mar;262(3):941-6. doi: 10.1148/radiol.11110618.


Purpose: To retrospectively examine the association between the inclusion of epidemiologic information in lumbar spine magnetic resonance (MR) imaging reports regarding findings in asymptomatic individuals and the rates of subsequent cross-sectional imaging and treatments in patients with low back pain or radiculopathy referred for imaging by primary care providers.

Materials and methods: Institutional review board approval was received for a retrospective chart review, with waiver of informed consent and HIPAA authorization. During 3 years, an epidemiologic statement was routinely but arbitrarily included in lumbar spine MR imaging reports. Two hundred thirty-seven reports documenting uncomplicated degenerative changes on initial lumbar spine MR images were identified, 71 (30%) of which included the statement (statement group) and 166 (70%) did not (nonstatement group). The rates of repeat cross-sectional imaging and treatments within 1 year were compared between groups by using logistic regression controlling for severity of MR imaging findings.

Results: Patients in the statement group were significantly less likely to receive a prescription for narcotics for their symptoms than patients in the nonstatement group (odds ratio = 0.29, P = .01). Repeat cross-sectional imaging and physical therapy referrals were also less common in the statement group than in the nonstatement group (odds ratio = 0.22 and 0.55, respectively), but these differences were not statistically significant (P = .14 and .06, respectively). Rates of steroid injections, surgical consultations, and surgeries were similar between groups.

Conclusion: Patients were less likely to receive narcotics prescriptions from primary care providers when epidemiologic information was included in their lumbar spine MR imaging reports.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chi-Square Distribution
  • Female
  • Humans
  • Logistic Models
  • Low Back Pain / diagnosis*
  • Low Back Pain / drug therapy
  • Low Back Pain / epidemiology*
  • Lumbar Vertebrae*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Narcotics / therapeutic use
  • Prevalence
  • Primary Health Care / statistics & numerical data
  • Radiculopathy / diagnosis*
  • Radiculopathy / drug therapy
  • Radiculopathy / epidemiology*
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • Risk Factors


  • Narcotics