When a patient complains of back or neck pain, doctors often order x-rays as one of the first diagnostic imaging tests. Many spinal disorders are easily seen on x-rays. If x-rays are inconclusive, additional diagnostic tests may be needed, including a CT scan or an MRI. Vertebrae show up well on x-rays; however, soft tissue injuries or damage are not usually detected on x-rays. Once the x-rays are read by a radiologist, a report is sent to the physician who ordered the imaging tests.
The following five spinal conditions are easily seen on x-rays: spinal fractures, spondylolisthesis, kyphosis, scoliosis, and osteoarthritis or bone spurs.
Spinal Fractures
Fractures are easily seen on x-rays. The most common fracture of the spinal vertebrae is a compression fracture. This type of fracture is composed of small cracks or breaks, commonly seen in persons with osteoporosis.
A type of compression fracture is the wedge fracture, which is on the front side of the vertebrae. This causes the front part of the vertebrae to collapse, making the bone appear like a wedge shape.
Burst fractures are more serious, causing the vertebrae to break into multiple pieces. They are often due to trauma such as a fall or accident. Burst fractures are often quite painful, causing swelling around the affected vertebrae, tingling or numbness, and a decrease in mobility.
Spondylolisthesis
In this condition, one of the vertebrae shifts out of its normal position and presses down on the vertebrae below it. It most often occurs in the low back and results in pain, stiffness, muscle tightness, tingling, or numbness. X-rays allow doctors to pinpoint the area of concern and help them determine an appropriate course of treatment.
Kyphosis
This condition is a curvature in the thoracic spine measuring 50 degrees or greater. It’s sometimes called a roundback, hunchback or dowager’s hump. X-rays help physicians determine the angle of the curvature. They may be repeated at six month intervals to monitor the progression.
Scoliosis
This is a side-to-side curvature of the spine, like an S or a C. It may be seen in children and adults. A scoliosis can cause back pain and abnormal posture.
Osteoarthritis and Bone Spurs
Osteoarthritis is a degenerative joint disease that causes pain, stiffness, swelling, and reduced range of motion. Bone spurs are a common side effect. These bony growths develop on the edges of bones and joints.
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