We have consistently written on the topic of MRIs and the fact that they often produce false positive findings, leading patients and their physicians on expensive and unncessary treatment courses, only to find the patient still left with his/her original pain complaint. In other words, the MRI documented finding was the cause of the patient’s pain. In our experience, the cause is often ligament and/or tendon laxity and/or joint instability. We find that these types of injuries do not show up well on MRI. Thus, the best way to determine the cause of the patients’ pain is by physical examination and talking to the patient (history).
A very recent study done at Penn State and pre-released for publication in the American Journal of Sports Medicinewebsite January 13, 2011 was undertaken to determine the prevalence of pelvic and hip MRI findings and their association with clinical symptoms in professional and college hockey players.
The study included 21 pro and 18 college hockey players. They were given self-reporting questionnaires to complete in conjunction with receiving 3-T MRI evaluations of the pelvis and hips. The results were interpreted by independent radiologists using the 5-point Likert scale to assess for features associated with common adductor-abdominal rectus dysfunction and hip pathology. MRI findings rated > 4 were considered positive.
None of the study participants reported symptoms related to pelvic or hip disorders. MRI findings of common adductor-abdominal rectus dysfunction were observed in 14 of 39 participants or 36% and hip changes in 25 of 39 or 64%. Overall 30 of 39 or 77% asymptomatic hockey players demonstrated MRI findings of the hip or groin abnormalities.
The authors conclude, “Given the high prevalence of MRI findings in asymptomatic hockey players, it is necessary to cautiously interpret the significance of these findings in association with clinical presentation. Future investigations will determine whether these asymptomatic findings predict future disabilities.”
About Prolotherapy commentary: Again this study goes to show that you cannot use MRIs for the purpose of diagnosis of many pain problems. If you want to get surgery, get an MRI. MRIs are done to prepare you for surgery.
Read more articles on MRIs
Video: Dr. Hauser discusses the role of MRI in diagnosing pain problems.