Abstract: To assess the cost and diagnostic value of back X-ray in patient with back pain.
Methods: in form of retrospective cross section study, the self-made data collection instrument was designed with all needed information. The study cover all patient with back pain went for X-ray with CT scan or M.R.I in one year duration started from July 2012 to July 2013 in National Guard Hospital. The data is collected from medical files in the medical record for total 295 patients.The collected data were statistically analyzed.
Results: Regarding radiology requests for assessment of back pain, X-ray plus MRI was frequently requested in the majority of cases (90.2%). Most patients were had a single request, while those requiring repeated requests were 8.5% for two requests, 1.0% and 0.3% for three or four requests.
Out of the total requested, back X-ray yielded 28.1% abnormalities in comparison with MRI and CT scan which yielded a positive diagnosis in 88.5% and 79.3% of cases; respectively. In this regards, in comparison with MRI, and CT scan back X-ray was able to detect 3 out of every 10 diagnosis for back pain while MRI and CT scan was able to detect diagnosis in 9 out of 10 and 8 out of 10; respectively in cases with back pain. Among those who had done the back X-ray for back pain together with CT scan; the proportion of back X-ray there a frequency of 78.6% mismatch with abnormal CT scan done for back pain. On the other hand regarding the back X-ray which was done together with M.R.I for back pain; the back X-ray mismatch frequency with abnormal M.R.I amounted to (96.8%). The cost of x-ray requested in addition to M.R.I was the highest amounting to almost SR 700,000.
Conclusion: back X-ray fails to detect abnormality in most of cases in compare with CT scan and M.R.I. it is lead to more cost and more radiation exposure and work load.so, generally it is not recommended. The clinical assessment is mandatory to evaluate the patient and request the proper form of radiology. Lumbosacral X-ray shows to be costly with minimum diagnostic value and high radiation exposure. Patient satisfaction should be reached by proper communication and trust with patient with detailed education rather than non-clinically indication for X-ray referral.
Keywords: Back pain, X-ray, CT MRI, Saudi Arabia.
Title: The Cost and Diagnostic Value of Back X-Ray in Back Pain
Author: Adel Nasser Al bargi, Abdulrahman Ahmed Al naim, Abdullah Khaled Al maqhawi, Ammar Abdulfattah Al kubaish, Suha Jafar Al Bahrani, Saleh Khaled Al Mogairen, Ibrahim Faris Al ruqi, Sayed Ibrahim Ali ,Essam AbdelBary
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
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