Evaluation of Incidental Findings on Lumbosacral MRI in Patients with Low Back Pain

Abstract

Background & Aims: Low back pain is one of the most common problems and a symptom-related reason for visits to a physician, and one of the important causes of disability. It may also impose great costs on the individual and the health system. Most patients with back pain will recover within 4 to 6 weeks. One of the best paraclinical diagnostic methods is magnetic resonance imaging (MRI), which may result in incidental findings of great importance to the patient. Methods: In this cross-sectional study, all cases in which lumbosacral MRI was performed due to back pain were investigated in terms of incidental findings. Results: The MR images of 854 patients in 2012 were studied. Among these patients, 40.3% (344) were male and 59.7% (510) were female. Mean age of patients was 43.05 years with median of 42 years. The incidental findings were observed in 29.7% (254) of cases who had no clinical symptoms and were not investigated by the physician. Abnormal incidental findings were observed in 9.5% (81) of male and 20.2% (173) of female patients; this difference was significant (P = 0.001). The prevalence of incidental findings was significantly higher in men of above 42 years of age (P = 0.001), but this difference was not significant in female patients (P = 0.513). In total, the prevalence of incidental findings was higher in ages above 42 (P = 0.004). The most prevalent incidental findings were, respectively, renal cysts (11.5%), retroflection of uterus (5.7%), and ovarian cyst (4.3%). Life threatening findings were aortic disorders (n=11, 11.3 %) and important lesions (n=28, 3.3%) requiring investigation. Conclusion: Incidental findings in MRI are important and since they might be the origin of pain or health threatening, require further evaluation.