Chronic Pain: Treatment Shouldn’t Be Based Solely On MRI Results

By Peter Zafirides, M.D. on February 11, 2012
Back Pain

As it relates to MRI results in patients with chronic hip pain,  what you see doesn’t dictate the treatment you should necessarily get.



Even our very best healthcare technologies have their limitations. As both clinicians and patients, we must always be aware of this reality. Yes, imaging breakthroughs – like magnetic resonance images (MRI) – give us an incredibly precise view of human anatomy. But how healthcare professionals relate those findings to actual chronic pain conditions – and then decide on the proper course of treatment – can be anything but straightforward. The latest study clearly illustrates this point.


According to research presented at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day in San Francisco, physicians should not replace clinical observation with the use of  MRI when it comes to treating people with hip pain.


“We performed MRI scans on a sample of volunteers without any hip pain, and discovered about 73% had abnormal findings,” said the study’s lead author Bradley C. Register, MD, of the Steadman-Philippon Research Institute.


The study evaluated forty-five volunteer subjects with no history of hip pain, symptoms, injury or previous surgeries. Each participant received an MRI scan which was reviewed by three separate radiologists. Scans identified tears of the labrum (cartilage that surrounds the hip joint) as the most common of the abnormalities displayed, making up nearly 69% of the joint conditions. Subjects (again, in no pain) older than 35 were more prone to many abnormalities being identified by the radiologist reading the films.


“The hope with a study like this is improved treatment and decision-making for physicians who are dealing with hip disorders,” noted Register. “Our results emphasize the importance of correlating clinical signs and symptoms with imaging findings when considering surgery for patients with these conditions.”


Yes this is a very small study – 45 volunteers. But, a 73% rate of abnormal findings in patients with NO pain (also known as a false positive) should gives us more than enough reason to pause for reflection as we consider the relevance of imaging studies in a patient with chronic pain, here specifically of the hip.

February 11, 2012

The Healthy Mind Network


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