This is an important article to read.
Many of the incentives today encourage doctors to order more advanced imaging scans, like CTs and MRIs. This expensive practice is invariably caused by this common scenario, as “patients who are in pain often demand scans hoping to find out what is wrong, doctors are tempted to offer scans to those patients, and then, once a scan is done, it is common for doctors and patients to assume that any abnormalities found are the reason for the pain.”
The problem is that these scans are so sensitive, incidental findings are often found. In many cases, they may not be the true cause of the symptoms, and worse, can necessitate more invasive testing that can have serious side effects.
CT scans expose patients to radiation, and scans that lead to biopsies can have the risk of bleeding and infection as complications.
The article focuses specifically on back and knee pain. It’s noted that mensicus tears are a function of aging, and if found, may not be the root cause of a patient’s pain. Similarly, those who undergo MRIs for back pain may find disk herniations. These however, may not require treatment as almost two-thirds of cases resolve within 6 months.
And here’s an important caveat. Patients who underwent back MRIs and knew about these findings fared no better than those who didn’t. In fact, “there was one effect of being told “” patients felt worse about themselves when they knew they had a bulging disk.”
As scans spread to applications ranging from cardiology (coronary CT scans) and gastroenterology (CT or “virtual” colonoscopies), patients need to be reminded again, that more advanced tests doesn’t necessarily equate to better care.