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MRI overuse and misuse really makes me angry. Did you know that a growing number of doctors don’t even read the tests themselves? Another shocking aspect of this industry is that some doctors will order an MRI because it’s quicker than doing an in-depth history or a good physical exam. That would take too much time, just order an MRI. Rushing to an MRI can oftentimes erase clinical correlation, that is, connecting the dots between pain and what the MRI shows.

MRI is unnecessarily overused. In a recent study of 221 patients who had MRIs, the results showed that only 5.9% actually needed to have an MRI done. The remaining 94.1% of the patients sacrificed their time and money. (Christopher W. DiGiovanni, M.D.) What’s worse is that the use of MRI for screening isn’t as effective as other methods.

MRI needs to be judicious and scrutinized by the physician who ordered it. It can be as dangerous as it is useful. Many patients view the MRI as a security blanket, and will go as far as requesting it. I have numerous cases of diagnostic problems that result from misuse of the MRI. The real problem is one of clinical correlation (making sure that what’s seen on MRI is in agreement with the patients problem) and the fact that any test including an MRI must be ordered to confirm a preliminary diagnosis that is already known or vey highly suspected from the history, exam, and more simple, inexpensive tests such as an x-ray. Here are a few examples…

Never Have Knee Surgery Based on an MRI Diagnosis

The Boom in M.R.I.’s: Concerns Grow on Costs and Overuse

New Thoughts on the Diagnostic Value of MRI in Foot and Ankle Surgery

If you suspect your doctor is just being quick or using MRI to reach that “aha” moment, then you’re in a bad scenario. When I order an MRI, I am 90% certain about what the results are going to show. Doctors need to have a clear-cut idea on what they can expect to see from the results. Next time you’re told to get an MRI, and your doctor has little clue to your diagnosis, you may want to get a second opinion. Also, be sure to ask the physician if they read the MRI themselves.

Nothing makes me quite as angry as the doctors who can’t or won’t read the MRI themselves.

Have you ever had an MRI? Did you question the necessity of it? Do you have a horror story?