Abstract
Background: Low back pain (LPB) is an important public health problem. It is a pain in the back between the ribs and the top of the leg that can result from several causes. An X-ray is a diagnostic tool that can be used for the diagnosis of LPB. This study was done to investigate the cost and diagnostic value of back X-ray in patients with back pain.
Methodology: This was a cross-sectional study that was performed using a self-made data collection instrument. The study was conducted on all patients with back pain, who went for X-ray and were compared with magnetic resonance imaging (MRI) or computed tomography (CT) scan. The study was performed during the period between July 2012 and July 2013 at the National Guard Hospital, Saudi Arabia.
Results: Back X-ray yielded 28.1% abnormalities as compared with MRI and CT scans, which yielded the positive diagnosis in 88.5% and 79.3%, respectively. In this regard, in comparison with MRI and CT scan, back X-ray was able to detect 3 out of every 10 diagnoses for back pain, whereas MRI was able to detect 9 out of 10, and CT was able to detect 8 out of 10 disorders in cases with back pain. The mismatch of back X-ray was 78.6% as compared with abnormal CT, whereas the mismatch of back X-ray compared with abnormal MRI was 96.8%.
Conclusion: Back X-ray is not recommended as it failed to detect abnormalities in most of the cases as compared to CT scan and MRI. It also causes more radiation.

Key words: Back X-ray, back pain, CT, MRI.