PARIPEX - INDIAN JOURNAL F RESEARCH | O September - 202 Volume - 11 | Issue - 09 | 2 | PRINT ISSN No. 2250 - 1991 | DOI : 10.36106/paripex ABSTRACT Introduction: Lumbar spine pathology is major healthcare burden encountered in district and urban hospitals. Diagnostic imaging in these patients is not always indicated. Imaging is considered in those patients who show little or no improvement in their LBP after approximately six weeks of medical management with or without physical therapy, the current study was undertaken to assess the appropriateness of LBP imaging in primary care following the ACP guidelines. The inclusion criteria for the study were adult patients with persistent low back pain with or Method: without radiculopathy post six weeks of medical management affecting their activity of daily living. And the exclusion criteria were spinal trauma , neurological impairment, bladder and bowel involvement, spinal malformations, history of malignancy presenting at the time of index visit. The study included total 115 patients. Out of 115 patients 87 Result: [70%] patients showed abnormal finding on the radiographs. The most common abnormal finding was disco vertebral degeneration such as spondylosis (osteophyte formation) in 49.6%. Routine x-ray imaging in low back Conclusion: pain patients is not always warranted. Moreover routine radiological imaging methods are not associated with meaningful clinical outcomes for the patients. Unnecessary imaging can lead to harmful radiation exposure of the patients and can further lead to additional medical expenditure and needless surgical intervention. Diagnostic radiological imaging should be used judicially. ORIGINAL RESEARCH PAPER Orthopaedics PREVALANCE OF RADIOLOGICAL INVESTIGATION IN LOW BACK PAIN – AN OBSERVATIONAL STUDY KEY WORDS: Low Back Pain, X-ray imaging, ACP guidelines www.worldwidejournals.com 3 Dr Parag M. Tank* Research Scholar(Ph.D Regn No. 9590- Gujarat University), Smt. NHL Municipal Medical College, Ahmedabad *Corresponding Author Dr Harsh N. Patel MS Orthopaedics, Smt. NHL Municipal Medical College, Ahmedabad Dr Dhaval Patel MBBS, Smt. NHL Municipal Medical College, Ahmedabad INTRODUCTION: Lumbar spine pathology is major healthcare burden encountered in district and urban hospitals [1]. Acute lumbar spine pain is up to six weeks whereas subacute pathology lasts up to twelve weeks. Chronic pathology lasts more the twelve to fourteen weeks[1]Majority of productive and active phase of a person suffering from these ailments receives treatment frequently and bear expenses and job layoff [2]. Andersson [3] in his studies described various incidence in person suffering from acute or chronic pathology. Current study was undertaken according to radiological investigations of American physicians. METHODOLOGY: The present study was undertaken at Smt Shardaben Municipal General Hospital, Ahmedabad affiliated to NHL Municipal Medical College. The patients coming to the outpatient department with LBP were invited to take part in the observational study. The inclusion criteria for the study were adult patients with continuous symptoms with/without radiculopathy post six weeks of medical management affecting their activity of daily living. And the exclusion criteria were spinal trauma, neurological impairment, bladder and bowel involvement, spinal malformations, history of malignancy presenting at the time of index visit. The subjects who met the inclusion criteria were selected and were informed and written informed consent was taken . The study included 115 patient in which 51 were males and 64 females. The duration of the study was one year. During the follow-up after six weeks of medical treatment, patients with no improvement of symptoms or worsening of symptoms underwent radiological imaging. MRI was also prescribed to those who did not have any positive findings in X Ray imaging and still presented with the symptoms. RESULTS: The data was collected and assessed using SPSS version 16 software. The study included total 115 patients who underwent x-ray imaging for low back pain. Patients characteristics are shown in Table 1. The patients were predominately female (55.6%). The maximum frequency of the patients who visited were between 46-55 years of age. Out of 115 patients 87 [70%] patients showed abnormal finding on the radiographs. Lumbosacral x-ray findings are shown in Table 2. The most common abnormal finding was disco-vertebral degeneration such as spondylosis (osteophyte formation) in 49.6% followed by loss of lumbar lordosis in 15.6% and narrowing of intervertebral foraminal space in 13%. 11.3% patients had scoliosis whereas 9.6% patients who underwent the radiological studies presented with spondylolisthesis grade one. Also there were 3.5% of patients who presented with sacroiliac joint disease. Only 11 patients needed MRI investigation in the study. Only 4.3% patients had to undergo surgical intervention whereas rest other patients were treated with analgesics with or without physiotherapy. TABLE 1: Patients Characteristics Table 2: Lumbo-Sacral X -ray Results DISCUSSION: Papageorgiou et al. [4] in his study found that half of the Dr Dhruvesh Katara MBBS, Smt. NHL Municipal Medical College, Ahmedabad AGE FREQUENCY PERCENT 18-25 13 11.3 26-35 25 21.7 36-45 21 18.3 46-55 28 24.3 56-64 17 14.8 65 and above 11 9.6 Total 115 100 Abnormal X Ray Findings Frequency Percentage Disco vertebral degeneration 57 49.6 Loss of lumbar lordosis 18 15.6 Narrowing of Intervertebral space 15 13.0 Scoliosis 13 11.3 spondylolisthesis 11 9.6 Sacroiliac Joint disease 4 3.5