A 48 year old man known to you with a long history of low back pain, presents once again with similar symptoms. He has had a previous X - ray showing degenerative disc changes 6 years earlier. What is to be done next?
High-Yield Explanation
In the absence of any 'red flag' signs, there is no indication for fuher X - rays. Red flag signs: Thoracic pain Fever Weight loss Bladder or bowel dysfunction Carcinoma history Neurological deficit Onset < 20 years or > 55 years. For neurological symptoms, MRIa best to examine just the spine. If systemic disease was suspected, CT would be best