ACE Clinical Guidances (ACGs)

[also known as Appropriate Care Guides]

ACGs provide concise, evidence-based recommendations to inform specific areas of clinical practice and serve as a common starting point nationally for clinical decision-making. ACGs are underpinned by a wide array of considerations contextualised to Singapore, based on best available evidence at the time of development. Each ACG is developed in collaboration with a multidisciplinary group of local experts representing relevant specialties and practice settings. ACGs are not exhaustive of the subject matter and do not replace clinical judgement.

Published on 01 Oct 2020
Last Updated on 01 Oct 2020
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This ACE Clinical Guidance (ACG) covers the use of magnetic resonance imaging (MRI) of the lumbar spine for diagnostic investigation of low back pain, providing evidence-based recommendations on the role of MRI for low back pain that is non-specific or linked to a specific spinal pathology.

Download the PDF below to access the ACG.

ACG recommendations
1. Patients with non-specific low back pain, with or without radicular symptoms: MRI is not indicated.
2. Patients with non-specific low back pain despite 4 to 6 weeks of conservative management: MRI may be indicated.
3. Patients with low back pain and progressive neurological symptoms or signs: MRI is indicated.
4. Patients with low back pain and suspected cauda equina syndrome: MRI is indicated.
5. Patients with low back pain and cancer or infection (suspected or known): MRI is indicated.
6. Patients with new or progressive low back pain following an invasive procedure on the lumbar spine: MRI is indicated.


When to order MRI for low back pain (Oct 2020)