Community Spinal Service
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You may wish to consider direct referral to the Community Spinal Service
Indications for MRI Lumbar Spine
Sciatica
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True sciatica with pain radiating below the knee, in patients less than 55 years where pain has been present for more than 6 weeks and showing no sign of improvement.
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Sciatica with worrying muscle weakness: especially foot dorsiflexion weakness or wasted quadriceps with giving way of the knee.
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Chronic sciatica (> 3 months) in patients over the age of 55 years, with no response to conservative treatment: may indicate spinal stenosis.
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Suspected cauda equina syndrome or spinal cord compression: refer as an emergency to the on-call Orthopaedic Registrar.
Non-specific back pain
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For patients with longstanding non-specific back pain with failure to respond to conservative treatment, seek referral to the Community Spinal Service .
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Do not request plain x-rays.
Other differential diagnoses:
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Osteoporotic fracture, request plain x-rays.
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Spinal malignancy or infection, seek an urgent hospital referral.
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Inflammatory back disease, seek a rheumatological referral.
Department of Radiology, RBH, April 2014