Urgent care emerges as a promising setting for imaging low back pain

Low back pain is a significant contributor to healthcare costs in the U.S., affecting a large number of patients. A study conducted by researchers at Mass General Brigham analyzed data from 16,754 lumbar spine imaging studies carried out in 23 of their urgent care centers and affiliated emergency departments over a period of seven years.

The findings revealed that only 24 out of 2,924 urgent care lumbar spine X-rays for uncomplicated low back pain resulted in emergency department advanced imaging within 30 days. This represents an extremely low rate of 0.8%.

The study, published in the Journal of the American College of Radiology, suggests that urgent care imaging may offer a less resource-intensive alternative to emergency department advanced imaging for certain lower back pain cases. An urgent care X-ray utilizes about one-quarter of the imaging resources required for an emergency department CT or MRI.

The study's senior author, Dr. Marc Succi, emphasized the importance of this discovery, stating that it could guide clinicians in determining when advanced imaging is likely to change care and when a less intensive evaluation may be appropriate. This decision holds implications for both patient care and the efficient use of limited healthcare resources.

The retrospective analysis identified one missed fracture among the 24 patients whose urgent care X-rays were followed by emergency department imaging within 30 days. Dr. Michael Hood, co-first author of the study, noted that all other findings were correctly identified on the original urgent care X-ray. This finding underscores the importance of examining return cases to ensure the accuracy and utility of the study's conclusions.

Dr. Succi highlighted the potential benefits of this approach, stating that "we're excited about the potential to evaluate selected patients with fewer imaging resources while preserving access to advanced imaging when needed." However, the researchers caution that further research is warranted to validate these findings through a prospective study across multiple health systems, tracking patients beyond the initial 30-day period to monitor subsequent care.