Spinal radiographs in those with back pain - when are they appropriate to diagnose vertebral fractures?

Emma Clark, Steve Cummings, John Schousboe

Research output: Contribution to journalArticle (Academic Journal)peer-review

8 Citations (Scopus)
554 Downloads (Pure)


The presence of an osteoporotic vertebral fracture improves fracture risk assessment and may change management, so it is vital for healthcare professionals to assess patients for the presence or absence of these fractures. This may be particularly important in the presence of back pain. However, the correlation between low back symptoms and spinal imaging results is poor and the pathophysiology of most low back pain is not known, leading to a common conclusion that spinal radiographs are not appropriate for the assessment of back pain. For individual patients with back pain, spinal radiographs should be considered if they have certain features in the history and examination. As well as the traditional risk factors for osteoporosis, self-reported descriptives of back pain and novel physical examination findings have been shown to make the presence of vertebral fractures more likely. Systematic approaches have the potential to improve bone health across the population, but need to be targeted to be cost-effective.
Original languageEnglish
Pages (from-to)2293–2297
Number of pages5
JournalOsteoporosis International
Issue number8
Early online date25 Apr 2017
Publication statusPublished - Aug 2017


  • Vertebral fracture
  • Back pain
  • Pain descriptives
  • Physical examination


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