{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T17:45:41Z","timestamp":1767203141570,"version":"build-2238731810"},"reference-count":53,"publisher":"Scientific Scholar","content-domain":{"domain":["clinicalimagingscience.org"],"crossmark-restriction":true},"short-container-title":["JCIS"],"abstract":"<jats:p>Many clinicians use radiological imaging in efforts to locate and diagnose the cause of their patient\u2019s pain, relying on X-rays as a leading tool in clinical evaluation. This is fundamentally flawed because an X-ray represents a \u201csnapshot\u201d of the structural appearance of the spine and gives no indication of the current function of the spine. The health and well-being of any system, including the spinal motion segments, depend on the inter-relationship between structure and function. Pain, tissue damage, and injury are not always directly correlated. Due to such a high incidence of abnormalities found in asymptomatic patients, the diagnostic validity of X-rays can be questioned, especially when used in isolation of history and\/or proper clinical assessment. The utility of routine X-rays is, therefore, questionable. One may posit that their application promotes overdiagnosis, and unvalidated treatment of X-ray findings (such as changes in postural curvature), which may mislead patients into believing these changes are directly responsible for their pain. A substantial amount of research has shown that there is no association between pain and reversed cervical curves. Accuracy can also be questioned, as X-ray measurements can vary based on the patient\u2019s standing position, which research shows is influenced by an overwhelming number of factors, such as patient positioning, patient physical and morphological changes over time, doctor interreliability, stress, pain, the patient\u2019s previous night\u2019s sleep or physical activity, hydration, and\/or emotional state. Furthermore, research has concluded that strong evidence links various potential harms with routine, repeated X-rays, such as altered treatment procedures, overdiagnosis, radiation exposure, and unnecessary costs. Over the past two decades, medical boards and health associations worldwide have made a substantial effort to communicate better \u201cwhen\u201d imaging is required, with most education around reducing radiographic imaging. In this review, we describe concerns relating to the high-frequency, routine use of spinal X-rays in the primary care setting for spine-related pain in the absence of red-flag clinical signs.<\/jats:p>","DOI":"10.25259\/jcis_5_2024","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T01:07:42Z","timestamp":1717549662000},"page":"18","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An investigation into the chiropractic practice and communication of routine repetitive radiographic imaging for the location of postural misalignments"],"prefix":"10.25259","volume":"14","author":[{"given":"Brogan","family":"Williams","sequence":"first","affiliation":[{"name":"Department of Research, The Association of Musculoskeletal Sports Physiologists, Auckland, New Zealand,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Gichard","sequence":"additional","affiliation":[{"name":"Department of Research, The Association of Musculoskeletal Sports Physiologists, Brisbane, Australia,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, College of Functional Movement Clinicians, Brisbane, Australia,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Louis","sequence":"additional","affiliation":[{"name":"Department of Research, Apollo Spine, Westville, Indiana, United States,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"key":"10.25259\/JCIS_5_2024\/ref-1","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s12998-018-0217-8","article-title":"Current evidence for spinal X-ray use in the chiropractic profession: A narrative review","volume":"26","author":"Jenkins","year":"2018","journal-title":"Chiropr Man Therap"},{"key":"10.25259\/JCIS_5_2024\/ref-2","first-page":"469","article-title":"Biomechanical analysis by chiropractic radiography: Part III. 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