Ironcoop wrote:
Yes - that's a different situation. He discusses the overuse of MRI's and the fact that by age 40+ (almost) all of us will have "something" show up on the MRI, even if it's completely unrelated to the actual cause. If you have time, I think you'd find his suggestions intriguing.
Thanks all!
I plan to listen to your podcast later but have not had a chance yet.
The OP suggested it being a red flag if your doc does not order imaging prior to a procedure. For that, I'd say it can be yes and no. I think a lot of docs rely on imaging too much, and not their clinical skills, to diagnose. When I was in med school, we were always taught to let the history/physical point you do the diagnosis. Your mind should be your sharpest weapon, and have the imaging studies as your back up (if needed). The other guy mentioned his ACL. I don't know the whole story so not sure what was discussed but, if the surgery has to be done (to repair the ACL) then the doc will be checking the meniscus and cartilage while he's in there. Doing the MRI is nice but it can sometimes just be an added expense (and extra step).
Also, MRI does not always show the "exact" problem. Or may raise a false alarm. An example of the first is my wife recently had knee surgery. She'd had an MRI of her left knee, a few years back, that showed meniscus damage. Because she was asymptomatic at the time, she and her surgeon chose no surgery. When it did finally start bothering her bad enough, he scoped her. Despite the MRI showing meniscus damage, that's not what he found once inside the knee. It was not her meniscus but a chunk of cartilage off the distal end of her femur. Her meniscus was actually ok. So, another newer MRI might've showed the cartilage damage but for what, he was going in the knee anyways. It would've been an extra expense and delayed her surgery. I was thankful he did not want to get another MRI.
A second example is myself. I developed high hamstring tendinopathy (HHT) a few years ago. MRI came back and showed almost equal amounts of inflammatory tendon changes on both my right and left sides. My problem was on the right. Ortho doc asked if I had any problems on the left and I said NO. To this day (knock on wood), I've never had HHT on the left......but my MRI suggested I do. So, this also goes back to the good and bad of imaging. Clinical correlation is always needed. And just because you find a "problem" does not mean you should always treat the "problem"