NICE NG59's 2024 amendment is short on paper and significant in practice — the imaging preference for non-traumatic low back pain with red-flag concerns shifted firmly to MRI as first-line, with CT explicitly reserved for cases where MRI is contraindicated.

Why this matters in the consult room

CT delivers a non-trivial radiation dose to the lumbar region — about 6 mSv per lumbar spine series, or two years of background radiation. For young adults with a long radiation-exposure horizon ahead, MRI's lack of ionising radiation is no longer a secondary consideration; it's a primary one.

What good AI scribes should be doing

  • Flagging when a CT lumbar request is being entered for a non-traumatic LBP case.
  • Surfacing the NICE NG59 reference inline, not buried two clicks away.
  • Showing the radiation-dose comparison without being preachy about it.
  • Letting the clinician override with a one-line rationale (logged for audit, not for judgement).

MedMETs does all four. The intent is never to override clinical judgement — it's to make sure the clinician has the latest guidance at the moment of the decision, not in a CPD review six months later.