X-rays, CT scans, Ultrasound tests and MRI results can often be misleading.
Modern imaging techniques provide us with a view of the body’s internal structures leading to the belief that anomalies on a scan must be the cause of a person’s problems.
However, this is not always the case. More and more research shows that many people with abnormalities on their scans have no pain and they function normally. On the flip-side, a person may have severe pain and limitation in their activities, yet their scans are perfectly clear and “normal”. The condition of the actual structure seen on X-ray or scan does not always present the full picture.
- (Jensen et al 1994) found that 64% of people without back pain had a disc abnormality on MRI,38% at more than one level.
- More recent studies showed similar findings (Brinjikji et al 2015).
- Disc bulges were observed in 88% of healthy patients, including those in their 20’s. radiology is similar (Nakashima et al 2015).
- Heerey et al 2018, found 54% of individuals without pain displayed a laberal tear on imaging.
- Ganderton et al 2017 found gluteal tendon injury in 88% of pain-free individuals.
- Han et al 2018), showed hip impingement deformity in 31% of patients without pain.
- MRI’s showed 16% patients without pain were found to have meniscal tears (Boden et al 1992).
- Rotator cuff tears were observed in 23% of patients after imaging their shoulders (Tempelhof et al 1999).
Treat the Person, Not the Picture
Despite the research, many people continue to place great significance on radiological findings, using them to incorrectly guide clinical treatment. Imaging may confirm a suspected diagnosis, or rule out a cancerous tumor, but the costs must be weighed against the benefit if it will not change the treatment. This includes exposure to large amounts of radiation, time out, and expense for the patient and the health care system.