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MRI Misconceptions

athleteathlete Posts: 60
edited 06/11/2012 - 8:34 AM in Lower Back Pain
As always, check with your doctor to see what bearing the MRI results has on YOUR particular clinical situation but please realize that many MRI findings may be incidental (MAY NOT BE THE PRIMARY CAUSE OF YOUR PAIN OR PROBLEMS).
- A truly NORMAL lumbar spine MRI REPORT with NO reportable findings is UNCOMMON from age 30-40+ on
- In other words, don't neccessarily get all excited/worried about mention of disc bulges(NOT a herniation) or even protrusions, mild degenerative facet disease, ligamentum flavum thickening, osteophytes, mild degenerative facet disease or degenerative disc disease (or loss of T2 weighted signal) since many asymptomatic people (people with no related symptoms) have these findings. Such findings may or not may be significant in YOUR particular case. Terminology may also be inconsistent among cargivers.
So, if your doctor doesn't seem overly excited about an MRI report with several minor findings it may mean that he/she isn't very excited about the report as it pertains to YOU.
- What are a few MRI findings that are more likely to better correlate with symptoms? 1) radicular (leg) symptoms>>>back symptoms (back pain is very nonspecific with numerous causes including causes that may not be well seen on MRI) especially if acute(several months) 2) larger protrusions or extrusions (disk herniations) that CORRELATE with your symptoms (each affected nerve root will produce specific clinical findings such as pain,numbness, or weakness in a specific anatomic location such as a certain part of a leg) 3) Significant central canal or spinal stenosis 4) or SIGNIFICANT degenerative changes
- What if you've had pain for a long time that is not explained by MRI? Your doctor(s) will have to determine the cause


  • This is so true what you are saying. However patients don't go for a routine MRI to my knowledge. Most doctors won't be ordering MRI's without clear clinical findings to justify the cost. Without justifying the reason for a MRI the insurance company could refuse to pay for such test. Typically anyone getting a MRI has had pain for several weeks or a injury has occurred and the doctors are ruling out something. Just because it doesn't show clearly on the MRI doesn't mean there isn't a problem either. MRI's are just another tool in the diagnoisis stage of finding the pain generator and should be combined with the other tools a doctor has at their disposal to diagnosis a condition. It is not unheard of for doctors to end up using exploratory surgery to find the root issue to a problem that is not being picked up on MRI imagery, but they are diagnostic test suggest there problem exist.
  • I agree with tam. MRI is 1 tool, an import one, but 1 of a number of tests.

    I have had several MRI(s) and CAT Scan(s). Including having them as follow up to discogram and myelogram tests. Put those all together and you have a pretty good road map. If not, then yes, I could see having to agree to exploratory surgery.
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