Imaging for back pain, PSA, etc

Another article looks at the question of whether imaging is helpful for the management of back pain.

Ever since my MRI in 1989, I've known I had an L5S1 disc herniation.  (I'm not alone, of course) The MRI didn't change my treatment – indeed, I think that in the first few years after my diagnosis .. I was less active because of it.

The pressure to do something and know what it is often is blamed on the patient, but I think physicians are guilty of such behavior just as much – if not more.  Patients learn from the physician .. and I can say with some confidence that patients and physicians can learn from each other to work toward healing without ordering unnecessary tests.

… and speaking of unnecessary tests, I ordered a PSA last week for a patient who had chosen (after lengthy discussions) not to have it done the previous two years. 

The result was not what we wanted .. and I thought instantly of the recent JAMA paper.  oy.

Next topic  …

Lyme disease is quite prevalent in these parts.  I've seen a handful of very severe cases, and saw my first case of a true Erythema Migrans rash today.  Impressive.