What You Should Know About MRI and X-Ray

Fun Facts for February…

This month I’m just giving you research-based facts about pain and imaging (MRI/X-Ray).  Hopefully you’ll find them fun or at the very least interesting! 

Low back pain: 

• 1 patient with low back and pain and right leg symptoms went to 10 different radiology centers.  She ended up with 49 distinct findings! Where you get your MRI and who interprets it has a direct impact on diagnosis. (Herzog 2017)

• Imaging cannot be used to determine pain. The lumbar spine of asymptomatic individuals contained findings such as disc degeneration, disc bulge, and disc protrusion. People WITHOUT pain have positive findings on scans!  (Brinjikji et al 2015 and Tonosu et al 2017)

Rotator Cuff Tears:

• Individuals with full thickness tears on imaging DO NOT require surgery.  75% of patients who chose non-operative care including physical therapy, reported no longer having symptoms or had reduced symptoms.  65% of persons with RTC tears are asymptomatic. (Boorman et al 2018, Dunn et al 2016, Kuhn et al 201), Yamamoto 2011, Girish 2011)

HIp and knee pain:

• Only 15% of patients with hip OA on X-Ray actually had hip pain.  (Kim et al 2015)

• Imaging of 50+ year old individuals.  They found you were equally likely to have positive findings on scans with pain and without pain. (Guermazi et al 2012)

Take home message: Just because it says it on an MRI/X-Ray does NOT mean you have to have pain or that it’s the reason you have pain! 

Bonus: Those of you out there concerned about knee osteoarthritis and the prospect of a knee replacement, coming to the gym is helping! Studies show that greater quad strength is directly related to DECREASED development of OA-related symptoms aka knee pain. (Segal 2010) Go ahead, give yourself a pat on the back!