No. We only use imaging if it's necessary to answer questions that we can't answer through the physical exam.
For instance, if a patient shows clear signs of a disc herniation and radiculopathy, the clinical examination can accurately locate the level of the lesion and determine the extent of sensory or motor deficit. However, we need imaging to understand:
- the size and shape of the herniation as this will affect prognosis
- the grade of nerve root compression as this will help us determine if we need to refer this patient back to his GP as a surgery may be needed.
- the presence of any confounding factors like Modic changes which will reduce the likelihood of responding to conservative management.
X-rays also help rule out any serious pathologies or instability. In short, we don't just X-ray everyone – we only use imaging when it's the best way to help our patients.
