ABI Value	Interpretation	Recommendation
Greater than 1.4	Calcification/vessel hardening	Refer to vascular specialist
1.0 - 1.4	Normal	None
0.9 - 1.0	Acceptable	None
0.8 - 0.9	Some arterial disease	Treat risk factor
0.5 - 0.8	Moderate arterial disease	Refer to vascular specialist
Less than 0.5	Severe arterial disease	Refer to vascular specialist

Red Flag	Concerning Dx	Next Steps
Fever, chills, rigors IV drug use Recent infection	Epidural abscess Osteomyelitis Discitis	Stat MRI or transport to ED
History of cancer, new onset of pain Unexplained weight loss Pain not reproducible	Cancer	X-Ray Sed rate, CRP studies MRI w/o labs
Urinary retention/ incontinence Fecal incontinence Motor deficits at multiple levels Perineal numbness Saddle anesthesia Decreased anal sphincter tone	Cauda equine syndrome	Stat Lumbar MRI or transport to ED
Recent severe trauma or less sever trauma with history of osteoporosis, use of corticosteroids and older age Extreme pain with movement	Vertebral compression fracture	Plain film X-Ray or CT

Among patients in the following age groups who are asymptomatic, a lumbar spine MRI will find about...
	20-30 years old	30-40 years old	40-50 years old	50-60 years old	60-70 years old	70-80 years old	80+ years old
Disc Degeneration	37%	52%	68%	80%	88%	93%	96%
Oisc Signal Loss	17%	33%	54%	73%	86%	94%	97%
Disc Height Loss	24%	34%	45%	56%	67%	76%	76%
Disc Bulge	30%	40%	50%	60%	69%	77%	84%
Disc Protrusion	29%	31%	33%	36%	38%	40%	43%
Annular Fissure	19%	20%	22%	23%	25%	27%	29%
Facet Degeneration	4%	9%	18%	32%	50%	69%	83%
Spondylolisthesis	3%	5%	8%	14%	23%	35%	50%

Patient Education & Self-Care

Reference Documents