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To the Editor: Dr Jarvik and colleagues¹ found that simple radiographs and rapid MRI yielded similar outcome for patients with back pain. Similarly, Kendrick et al² previously reported that patients who had radiographs had outcomes similar to those of patients who had no imaging at all. Taken together, these 2 studies suggest that neither radiographs nor MRIs are useful as routine diagnostic procedures for back pain. Comparing one useless diagnostic procedure with a similarly useless one distracts from the fact that, in most cases of back pain, no imaging is best and least expensive.

Edzard Ernst, MD, PhD, FRCP(Edin)
Complementary Medicine
Peninsula Medical School
University of Exeter
Exeter, England

1. Jarvik JG, Hollingworth W, Martin B, et al. Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial. JAMA. 2003;289:2810-2818. FREE FULL TEXT 2. Kendrick D, Fielding K, Bentley E, Kerslake R, Miller P, Pringle M. Radiography of the lumbar spine in primary care patients with low back pain: randomised controlled trial. BMJ. 2001;322:400-405. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290:1852.

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