Low back pain and x-ray films of the lumbar spine: a prospective study in primary care.

We prospectively studied 96 men with low back pain to evaluate the association of x-ray findings with clinical diagnosis, treatment, functional outcome, and satisfaction with care. Degenerative joint disease (DJD) was the most common radiologic finding (70%). Making the diagnosis of spinal DJD has little effect on patient management, but patients with x-ray evidence of DJD were three times more likely than those with normal films to receive nonsteroidal anti-inflammatory drugs other than aspirin. Furthermore, patients given a "diagnostic label" of DJD were more likely to express satisfaction with medical care and less likely to seek care elsewhere than patients with similar x-ray results who were given nonspecific diagnoses. These factors will need to be considered in arriving at an estimate of the net benefits of x-ray examination of the lumbar spine.