• Jason Oswell

Good news for your 'bad' MRI scan


Have you ever had an MRI scan following a musculoskeletal injury and the results have come back showing problems?

With bad MRI results comes concern, anxiety and a big question: what next?

This blog is intended to put MRI results into perspective. It will make you think outside the box and hopefully make you feel a little better about your ‘bad’ MRI scan!

Firstly, I want to highlight, if you were to scan everybody in the world, most people would have abnormalities showing in every joint of their body. But this does not mean it is causing them pain. Take the back for example:

Many people dread the word ‘slipped disc’ and the associated back pain nightmare that comes with it. Although as you can see from the table below, around 50% of pain free 40 year olds have a disc bulge (‘slipped disc’) (1).

(1)

Over 30% of 20-year olds have disc degeneration and by the age of 80 you almost have a full house! But, I emphasise, this is in pain free subjects.

Take a look at the chart below. The difference between abnormalities in painful knees compared to pain free knees is small. Up to 72% of pain free 50 year olds suffer from cartilage damage (2).

(2)

You may be thinking ‘this only applies to the older generation’. But even in a population of pain free sports players in college, up to 71% can have issues with the labrum within their hip (3). More besides, in pain free baseball players aged between 18-22, over 65% show rotator cuff tendinopathy (4). These changes are often brought on as the body adapts to the demands that are inflicted upon it. It doesn’t mean the abnormalities cause pain or need ‘fixing’.

The concept of this blog is difficult to comprehend. It begs many questions. But we will take a look at ‘what does this mean’ in the next blog, including what this means for surgical interventions. But for now, take away a big positive. You may have a few abnormalities on your MRI scan, but you are not alone! Most people do!



REFERENCES:


1. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am J Neuroradiol. 2015. doi:10.3174/ajnr.A4173

2. Guermazi A, Niu J, Hayashi D, et al. Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: Population based observational study (Framingham Osteoarthritis Study). BMJ. 2012. doi:10.1136/bmj.e5339

3. Gallo RA, Silvis ML, Smetana B, et al. Asymptomatic hip/groin pathology identified on magnetic resonance imaging of professional hockey players: Outcomes and playing status at 4 years’ follow-up. Arthrosc - J Arthrosc Relat Surg. 2014. doi:10.1016/j.arthro.2014.04.100

4. Del Grande F, Aro M, Jalali Farahani S, Cosgarea A, Wilckens J, Carrino JA. High-resolution 3-T magnetic resonance imaging of the shoulder in nonsymptomatic professional baseball pitcher draft picks. J Comput Assist Tomogr. 2016. doi:10.1097/RCT.0000000000000327

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