Back pain is one of the main reasons for consultation in pathology of the musculoskeletal system. Pain can sit at the lumbar spine (low back pain), thoracic spine or cervical spine. This pain can be accompanied by limb pain related to irritation of spinal nerve root: sciatica, femoral neuralgia, intercostal neuralgia, cervicobrachial …
These pains are often related to aging of the sspine, discs, facet joints, ligaments …
Medical imaging is used to specify the exact origin of pain. The appropriate techniques for the study of the spine are:
1. MRI that allows a precise anatomical study of injuries and possibly their evolutionary character or not.
2. The X-rays that allow essentially a study of the shape of the spine. The analysis of injury is significantly precise month in MRI.
CT scanner can be requested for bone analysis or possibly to replace MRI. Ultrasound showed no interest.
When doing a spine imaging exam?
In a context of back pain in a patient without intercurrent serious or even sciatica, the first treatment is symptomatic: pain killers and anti-inflammatories. In this case, no imaging examination is necessary.
In case of persistent pain after the first treatment (3 weeks- 1 month) in case of atypical pain, not mechanical look, it seems legitimate to propose an imaging examination. It is customary to provide a radiographic examination first. This one is often disappointing because not used to precisely analyze the damage. The first intention of MRI is in our view entirely legitimate.
The radiographs of the spine.
There are two types of X-ray examinations of the spine: X-rays of the spinal segment (cervical, thoracic or lumbar) for a study of the origin of the lesions, radiographs of the entire spine standing for analyzing the shape of the spine. New digital radiographic techniques (EOS *) allow study not only the overall shape of the spine but also segmental analysis.
The radiographs of the entire spine.
Interest radiographs of the entire spine is to analyze the shape and face of the column profile support and extract the spinal parameters.
The cervicobrachial neuralgia.