Welcome to the official Newsletter of Advanced Medical Care.
Can You Trust The MRI?
We all love MRIs! They're great! You've had an xray, you've seen a specialist, and you're still not sure what the problem is. So you get an MRI. And that settles it. Xrays may be good for bones, but MRIs can see the discs in your low back, or the ligaments and tendons in your shoulder.
After the MRI you meet back with your doctor who has the MRI report and now you get the real story! Right?
The MRI Report May Be Wrong!
Maybe not. As it turns out, even after the MRI has been done, there may still be questions. A number of interesting reports have questioned how accurate MRIs are.
It is true that MRIs are generally considered the ‘gold standard’. But current reports show that even with an MRI report, doctors may end up with the wrong diagnosis, they may do an unnecessary surgery, or do the wrong treatment leading to a poor outcome for the patient.
Different Doctors Get A
Different Diagnosis on the Same MRI
According to a report back in 2014, when the same MRI is interpereted by different physicians, there is at least a 10% chance of a different interpretation, and often a 25 to 40% chance of a different interpretation. (The Spine Journal 14.10 (2014): 2442-2448.)
MRIs in patients with suspected medial meniscus tears of the knee were interpreted wrong in about 1 out of 4 of cases; anterior cruciate ligament tears were incorrectly diagnosed in 22% of cases, when arthroscopy revealed no tears. (American Journal of Roentgenology 207.2 (2016): 369-377)
In another trial the same patient was sent to 10 different MRI centers over a 3 week period of time. The results? Fourty nine distinct findings, 16 unique findings, and just 1 consistent finding. The authors of that report stated that the MRI center and the radiologist that interprets the examination directly impacts the ultimate diagnosis, choice of treatment, and clinical outcome. (The Spine Journal 17.4 (2017): 554-561)
When positive films with a known abnormality, that had been previously interepreted by a group of experts was presented to radiologists, there was a 33% error rate in their interpretation. (Radiology 52.3 (1949): 309-328)
Who Is reading These MRIs?
A radiologist is a physician whose specialty is interpreting xrays and MRIs. You do want the benefit of their interpretation, but remember this. That radiologist might be looking at a toe xray one minute, then looking at a CT scan of the brain, and then looking at your shoulder MRI.
A Second Opinion Always Helps
In my experience radiologists are pretty good, but that is a lot of anatomy for them to keep track of. You want the radiologists opinion to be supplemented by your own specialist. IE, if you did a shoulder MRI, you also want your shoulder surgeon to look at the MRI. If both opinions concur you can have more confidence in the diagnosis. But even then, you might need to seek another opinion.
You Are Entitled to Another Opinion!
An MRI is a great tool, just like every other medical test, but they aren't infallible, nor are the radiologists that read the MRIs. If in doubt, ask for another opinion!
Take care and BE HEALTHY!
Cary "CW" Jasper
October 2023
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