the lumbosacral spine Xray

see also:

• back pain in the ED
• CT spine - cervical (Cx), thoracic (Tx) or lumbar (Lx)
• lumbar spine trauma
• trauma
• spondylolisthesis
• radiology
• NICS - Lumbar spine imaging in low back pain 2008 (pdf)
• DFTB How to interpret thoracolumbar spine Xrays

• the lumbosacral spine Xray is NOT usually indicated in the ED unless there is significant risk of finding pathology such as:
  • fracture risk?
    • major trauma
    • minor trauma if >50 years old, with a history of osteoporosis, and/or taking corticosteroids
    • possible unstable Chance fracture - severe hyperflexion injury eg. MVA with lap belt, fall from a height
  • malignancy risk (XR shows evidence of tumour in 90% of vertebral metastases)
    • PH malignancy
    • >50 years old
    • Unexplained weight loss (e.g. >4.5kg in <6 months)
    • Pain at multiple sites
    • Pain at rest