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Diagnostic accuracy of MRI for identifying posterior element bone stress injury in athletes with low back pain: a systematic review and narrative synthesis
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  • Published on:
    Best test for diagnosing PEBSI.
    • Irina Obedkova, Nuclear Medicine Medical Resident Puerta de Hierro University Hospital , Madrid

    Dear colleagues, I have read with a great interest this systematic review “Esh R, Grødahl LHJ, Kerslake R, et al. Diagnostic accuracy of MRI for identifying posterior element bone stress injury in athletes with low back pain: a systematic review and narrative synthesis”[1] and would like to make some comments. Further research, as authors concluded, are always desired and I wish there are appropriate studies in the next future to decide if MRI could be a modality of choice for diagnosing PEBSI and not SPECT/CT as it is by now. But the referred articles from this review do not support this assertion for the following reasons.
    First, there are just 2 articles from 4 included in this review compared MRI and SPECT/CT and just in 1 of them (Juvenil spondilolysis: a comparative analysis of CT, SPECT and MRI) the results of both techniques were concordant, although the main causes of discrepancy were between MRI and SPECT/CT for diagnoses of stress reaction in absence of overt fracture and distinguishing incomplete fracture from intact pars of complete defects (22 patients and 40 pars defect) [2].
    Second, in the 2nd article the authors mention that sensitivity and specificity of MRI was 80 and 100% respectively skipping the SPECT/CT results and author’s conclusion that in the original article was following: “These results suggest that there is a high rate of active spondylolysis in active athletes with low back pain. MRI is inferior to bone scintigraphy (with SPECT)/c...

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    Conflict of Interest:
    None declared.