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Diagnostic Evaluation of Low Back Pain with Emphasis on Imaging
Ann Int Med 137:586-597, Jarvik,J.G. &Deyo,R.A., 2002
See this aricle in Pubmed

Article Abstract
The data suggest a diagnostic strategy similar to the 1994 Agency for Health Care Policy and Research guidelines. For adults younger than 50 years of age with no signs or symptoms of systemic disease, symptomatic therapy without imaging is appropriate. For patients 50 years of age and older or those whose findings suggest systemic disease, plain radiography and simple laboratory tests can almost completely rule out underlying systemic diseases. Advanced imaging should be reserved for pati ents who are considering surgery or those in whom systemic disease is strongly suspected.
 
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