With the rapid development of science and technology, medical equipment is constantly updated and improved, the auxiliary examination means for patients are constantly progressing, and people’s understanding of diseases is deepening; at the same time, the cost of medical examination is also correspondingly increased, which has increased the economic burden on the health expenditure of the majority of farmers and some grassroots residents. Neck, back and leg pain is the most common disease in orthopedic outpatient clinics. What tests should be done when going to the hospital with neck, back and leg pain, that is, diagnose the disease and save economic expenses? First, the doctor conducts a careful physical examination related to low back and leg pain to make a certain preliminary judgment of the disease. Secondly, the doctor decides whether relevant ancillary tests are needed. If so, which tests are done? Should multiple tests be performed at once or should the next test be performed based on the results of each test combined with clinical analysis and judgment? X-ray examination of the cervical and lumbar spine: It is very meaningful to determine whether the physiological curvature of the lumbar spine exists, whether there is lumbar degenerative scoliosis, whether there is osteophyte growth, whether there is bone destruction, whether there are “bamboo-like” changes in the spine, whether there is lumbar spine slippage, whether there is lumbar isthmic fracture, etc. Meanwhile, lateral films of cervical and lumbar hyperflexion and hyperextension can be taken to help understand The stability of the cervical and lumbar spine, and the standing X-ray film of the lumbar spine has very important clinical significance in determining the stability of the lumbar spine in the standing position, which cannot be replaced by CT and MR of the lumbar spine. X-ray examination is the basic examination means for cervical and lumbar pain. CT examination of cervical and lumbar spine: CT examination has better superiority to bone tissue and superiority to MR in determining the presence or absence of bone destruction. For patients suspected of bone tuberculosis and bone tumor, it is necessary to perform CT three-dimensional reconstruction examination, which can determine the extent of bone destruction and the presence or absence of abscesses around; CT scan or three-dimensional reconstruction for patients with X-ray suspected fracture or clinically suspected fracture with normal X-rays can improve CT scan of the intervertebral disc can determine the presence of lumbar disc herniation and lumbar spinal stenosis, and for patients with metallic materials (except titanium) in the body, as most of them cannot receive MR examination, CT after myelography is beneficial to improve the diagnosis rate and accuracy of lumbar disc herniation and lumbar spinal stenosis; for patients suspected of In patients with suspected discogenic pain, post-myelography CT scans can determine the extent of disc degeneration and the “responsible” segment of low back pain. Of course, the disc tissue that is free in the spinal canal after prolapse may be missed, resulting in a missed diagnosis. If conditions permit, for patients who are to be operated on, it is not possible to operate on the basis of CT results alone before surgery, and it is recommended that lumbar MR be done, which will facilitate a clear preoperative diagnosis, formulate a detailed surgical plan, and improve the clinical effect of surgery. CT examination can only be performed in a lying position and cannot determine the stability of the cervical or lumbar spine, which means that it cannot completely replace X-ray. MR examination of the cervical and lumbar spine: MR is superior to soft tissues, so it is an essential examination for patients suspected of spinal cord injury, which can determine whether there is external compression of the spinal cord, whether there is edema, hemorrhage, partial or total spinal cord rupture, etc. CT examination cannot provide the above information. After taking cervical spine X-ray in patients with suspected cervical spondylosis, cervical spine MR examination can be taken if necessary to determine whether the spinal cord is compressed, the degree of compression, and whether the compressor comes from the anterior or posterior side of the spinal cord. The significance of the examination of the spinal cord is not significant. MR examination of the lumbar spine can determine whether the dura mater and nerve roots are compressed in sagittal, coronal and cross-sectional views, the degree of compression, whether the protruding disc breaks through the posterior longitudinal ligament, whether it is free in the spinal canal and whether it has moved up and down, etc. The soft tissues around the vertebral body can be visualized more clearly than CT, which is helpful in determining whether there is soft tissue infiltration around the spinal tumor. In addition, MR is very accurate in determining whether a spinal fracture is fresh or old, and water imaging of the lumbar spinal canal can, to some extent, replace myelography. MR examination, like CT, can only be performed in a lying position and cannot determine the stability of the cervical or lumbar spine, which means that it cannot completely replace X-ray. In summary, for the examination of cervical and lumbar pain, X-ray, CT and MR examination each have their own advantages and disadvantages and cannot completely replace each other, which means that reasonable examinations can be performed according to the needs of the condition, and the expensive MR and CT cannot completely Finally, I would like to suggest to the average patient to accept the doctor’s suggestion to perform X-ray examinations, and to abandon X-ray examinations and directly ask the doctor to perform the so-called precise and advanced examinations – MR examinations, which can sometimes lead to missed diagnoses. Let me tell you a short story: Mr. Li, who was over 70 years old, had low back and leg pain for 2 years, and in the past 3 months, the pain had increased significantly, and the low back and leg pain appeared after standing or when walking and could not be relieved, and the pain was relieved or disappeared soon after bed rest. After Mr. Li went to the hospital, the doctor suggested him to take a lumbar X-ray film, and he requested a direct lumbar MR examination. The lumbar MR results showed that the lumbar spine sequence was normal and the lumbar spinal canal was narrowed. However, his clinical symptoms did not match, so the doctor suggested again that he take a standing X-ray of the lumbar spine, and the results showed: lumbar degenerative slippage (degree II), which matched his clinical symptoms. If Mr. Li had accepted the doctor’s suggestion to take a standing X-ray of the lumbar spine for the first time, he could have made a clear diagnosis and saved money. Why was lumbar degenerative slippage missed in the lumbar MR examination? It turns out that lumbar MR can only be performed in a lying position, and Mr. Li’s slipped lumbar spine was reset in a lying position, so the lumbar MR was missed. Instead, the lumbar spine slipped when the standing X-ray film was taken, reflecting the normal state of the disease. For patients who are able to stand, taking X-ray films of the lumbar spine or thoracic spine in a standing position should be chosen as much as possible to accurately reflect the pathological changes in the thoracolumbar spine.