should be performed in trauma, to assess bony alignment - e.g. in rheumatoid patients (flexion and extension lateral views) - and to delineate osteoarthritis (OA)
in non-traumatic acute neck pain x-ray examination is not usually helpful as most resolves on conservative management, but after 6-8 weeks with no improvement, or if lifestyle is affected or focal neurology demonstrated, or in those with a history of malignancy, specialist referral is indicated
General Indications for x-ray examination
Bony tenderness
Inability to weight-bear
Acute joint pain
Gross joint deformity
Acute spinal pain in elderly (to rule out osteoporotic wedge fracture)
Reference:
1) Arthritis Research UK (Summer 2013). Hands on - Musculoskeletal imaging for GPs.
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