Diagnostic Tests

Diagnostic tests can indicate if a patient's back pain is due to an anatomic cause. However, because diagnostic tests in and of themselves are not a diagnosis, arriving at an accurate clinical diagnosis requires any test to be to be correlated with the patient's back pain symptoms and physical exam.

The most common diagnostic tests include:

X-ray: This test provides information on the bones in the spine. An x-ray is often used to check for spinal instability (such as spondylolisthesis), tumors and fractures.

Ultrasound Imaging: This test uses sound waves to produce pictures of muscles, tendons, ligaments and joints throughout the body. It is used to help diagnose sprains, strains, tears and other soft tissue conditions. Ultrasound is safe, noninvasive and does not use ionizing radiation.

CT scan. This test is a very detailed x-ray that includes cross section images. CT scans provide details about the bones in the spine. They may also be used to check for specific conditions, such as a herniated disc or spinal stenosis. CT scans tend to be less accurate for spinal disorders than MRI scans.

MRI scan.

An MRI scan is particularly useful to assess certain conditions by providing detail of the intervertebral disc and nerve roots (which may be irritated or pinched). MRI scans are useful to rule out spinal infections or tumors.

Injections: Injections may also be used to help diagnose certain types of pain. If an injection of a pain relieving medication into a certain spot in the spine provides back pain relief, than it confirms that is the area causing pain.

Laboratory: CareFirst has a certified highly complex CLIA laboratory with immunoassay, gas spectrometry, and liquid chromatography capabilities. Toxicology testing is used to identify substances affecting a patient and to guide the clinician to predict future toxic effects, to confirm the differential diagnosis or to guide therapy.

Urinary drug testing objectives:

• Identifies absence of prescribed medication and potential for abuse, misuse, and diversion
• Identifies undisclosed substances, such as alcohol, unsanctioned prescription medication, or illicit substances
• Identifies substances that contribute to adverse events or drug-drug interactions
• Provides objectivity to the treatment plan
• Reinforces therapeutic compliance with the patient
• Provides additional documentation demonstrating compliance with patient evaluation and monitoring
• Provide diagnostic information to help assess individual patient response to medications (e.g., metabolism, side effects, drug-drug interaction, etc.) over time for ongoing management of prescribed medications.