Is MRI useful for evaluation of acute low back pain?

Abstract

Magnetic resonance imaging (MRI) is rarely helpful in the evaluation of acute low back pain. Limited evidence suggests that MRI may be useful in further assessing “red flags” in the history or physical exam. MRI has a high sensitivity and specificity in the detection of cancer or infection, but it is not particularly specific when evaluating lumbar radiculopathy. Poor specificity can lead to finding clinically irrelevant abnormalities.1 The overall evidence for the appropriate use of MRI in low back pain is limited and weak2,3 (strength of recommendation: C, based on limited randomized controlled trials).