Wording wisely: Including prevalence data and evidence based clinical outcomes of spinal and musculoskeletal degeneration in radiology reports.

Diseases due to spinal and musculoskeletal degeneration are a common cause of disability worldwide. In the past few years, there has been widespread increase in the use of imaging in these conditions. However, the years lived with a disability has not declined. There is a growing body of evidence that imaging in spinal and musculoskeletal conditions due to degeneration and ageing is unnecessary and contributes to increasing costs. More worrying is the evidence that imaging may also cause harm due to prevalent use of cortisone injections and surgical procedures that are justified on the basis of a radiology report. Prevalence studies and randomized controlled trials in the past decade have provided a better understanding of these diseases beyond the morphological findings described in a radiology report. A radiology report supplemented with information on normal age related appearances, natural progression, available evidence on treatment and subsequent health outcome may help the referrer and patient understand the relevance of imaging findings in a patient specific context. This may reduce unwanted procedures, unnecessary costs and patient harm. This article attempts to provide such information for the most common degenerative diseases of the spine and musculoskeletal system.