Correlating Plain Radiographic Finding with Magnetic Resonance Imaging Among Patients With Chronic Lower Back Pain in Tikur Anbesa Specialized Hospital, Addis Abeba ,Ethiopia.

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Addis Abeba University


Background Low back pain (LBP) is one of the leading causes of activity limitation and work absence throughout the world, imposing a high economic burden on individuals, families, communities, industry, and governments. Chronic lower back pain (CLBP) is one of the most frequently encountered patient visits in the outpatient setup like Regular clinics of general hospitals and specialty clinics of Neurology, Neurosurgery and Orthopedics departments. These patients usually present with non specific lower back pain which makes the differential diagnosis wide, there by imaging has a big part in reaching at the diagnosis in addition to the clinical evaluation. Plain radiography and MRI are the principal imaging modalities that are used in LBP. As to my knowledge there are only few studies done in our country on the prevalence of lower back pain and there are no published papers related to imaging of lower back pain. Objective: To correlate the imaging findings of Lumbosacral radiograph with MRI among patients with chronic lower back pain at TASH and ZMH, Addis Ababa, Ethiopia. Methods and materials: A cross sectional study design was applied. We collected 174 patients during the study period who presented with CLBP having both plain radiograph and MRI of the Lumbosacral region at the Neurology clinics of Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital. Data collectors administered a structured questionnaire to collect the data. The collected data was then entered and cleaned using IBM SPSS version 20 for statistical analysis. We set the significance level at P<0.05. Results: A total of 174 patients who presented with CLBP having both plain radiography and MRI were included to the study. The majority were female with male to female ratio of 1:2.5. The patients age range from 19 to 84years, two third of the patients being more than 40 years of age. The most common imaging findings were osteophytes, reduced disc height on both imaging modalities. Osteophytes (anterior and posterior) were seen in 70.7% on plain radiographs and 50.6% on MRI. Disc lesions were more prevalent on MRI 91.4% compared to 48.3% for plain radiography. MRI was found to be able to further characterize the disc lesions. The commonest disc disease on MRI was disc bulge 39.8%, disc herniation 33.1%. Statistically significant differences in occurrence of positive imaging findings were observed between the different age groups. Osteophytes and degenerative disc diseases were more common in the older age groups. 7 Conclusion: Findings in this study showed that the commonest imaging findings were osteophytes and reduced disc height, which were depicted both on plain radiographs and MRI. The two imaging findings correlated well. Increasing in age was important risk factor to degenerative disease. Recommendations: Chronic lower back pain especially in association with radiculopathy requires radiological imaging most importantly MRI.



Low back pain