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Chiropractic Research Review

How Accurately Do DCs Interpret X-rays?

Spinal radiographs are an integral part of chiropractic care; because X-rays are often used for treating low back pain (LBP) patients, practitioners should be able to properly diagnose using this tool.

In the Netherlands, primary care physicians do not take or interpret radiographs of their patients; this is done by radiologists. Few studies have evaluated the efficacy of chiropractor evaluations of plain radiographs.

To determine the reliability of chiropractors in the Netherlands to discover contraindications to chiropractic treatment based on radiographic findings, three chiropractic radiologists, five chiropractors and five medical radiologists each assessed 300 sets of lumbosacral radiographs. Pathology, which appeared on 50 of the radiographs, included malignancies, spondylitis, infections and spondylolysis/listhesis.

Results: All three groups were able to adequately identify contraindications based on radiographs. Differences between the three groups were small and considered of "little clinical relevance."

Conclusion: According to the authors, interpretation of radiographs should not be restricted to medical radiologists. They suggest forming strong professional relationships between medical doctors and chiropractors, to promote consultation in the event of a DC being unsure of findings.

De Zoete A, Assendelft WJJ, et al. Reliability and validity of lumbosacral spine radiograph reading by chiropractors, chiropractic radiologists, and medical radiologists. Spine 2002:27(17), pp. 1926-1933. www.spinejournal.com

Chiropractic Research Review

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