• E Millán Ortuondo, A Cabrera Zubizarreta, J Muñiz Saitua, C Sola Sarabia, and J Zubia Arratibel.
• Subdirección de Asistencia Sanitaria, Osakidetza-Servicio Vasco de Salud, Vitoria, España. Electronic address: eduardo.millanortuondo@osakidetza.net.
• Rev Calid Asist. 2014 Jan 1;29(1):51-7.

IntroductionLow back pain is a common disorder that generates many medical consultations. Magnetic Resonance Imaging (MRI) is commonly used in the clinical management of some of these patients. However, the cost of inappropriate MRI use is high, so there is a need to develop guidelines to help physicians make correct decisions and optimize available resources.ObjectiveTo determine the main clinical indications for MRI scanning in adults with low back pain.Material And MethodsThe RAND/UCLA appropriateness method was used: After a systematic review (May 2012), a list of the clinical indications for MRI scanning in patients with low back pain was prepared. A multidisciplinary expert panel scored each indication from 1, «totally inappropriate» to 9, «totally appropriate». A first on-line round, an in-person panel meeting, where results of the first round were discussed, and a final second on-line round were arranged. A clinical indication was considered appropriate if the median score was 6.5 or higher, and there was agreement between experts (IPRAS index was used).ResultsAn MRI test is considered appropriate if cancer, spinal infection or a fracture, even with a negative X-ray test is suspected.; if there is inflammatory back pain; severe/progressive neurological deficit; severe and progressive low back pain; subacute or chronic low back pain with radicular involvement unresponsive to conservative therapy.ConclusionsClinical indications for a MRI scanning are based on the suspicion of a secondary serious pathology. This methodology helps to set clinical indications for MRI, and may be of great value for both clinicians and health managers.Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

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