Reliability and Accuracy of MRI in Orthopedics: A Survey of Its Use and Perceived Limitations

Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders

Short Report

Joseph N Liu¹  Nirav H Amin²  Aman Dhawan³  Andrew Hong⁴  Anirudh K Gowd⁵ 

[1] Loma Linda University Medical Center, Loma Linda, CA, USA;Loma Linda University Medical Center, Loma Linda, CA, USA;Veterans Affairs Loma Linda Healthcare System, Loma Linda, CA, USA;Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA;School of Medicine, Loma Linda University, Loma Linda, CA, USA;Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA;

关键词: MRI;    survey;    diagnostic utility;    knee;    shoulder;    reliability;    accuracy;    orthopedics;   

DOI  :  10.1177/1179544119872972

 received in 2019-07-18, accepted in 2019-07-19,  发布年份 2019

来源: Sage Journals

【 摘 要 】

Over the past decade, the use of magnetic resonance imaging (MRI) as a diagnostic tool has been increasing significantly in various fields of medicine due to its wide array of applications. As a result, its diagnostic efficacy and reliability come into question. Specifically, in the field of orthopedics, there has been little discussion on the problems many physicians face while using MRIs in practice. To gauge the perceived limitations of MRI, we designed a decision analysis to analyze the utility of MRIs and estimate the number of inconclusive MRIs ordered within an orthopedic practice to explore potential alternative avenues of diagnosis. A survey of 100 board-certified practicing orthopedic surgeons given at 2 national conferences was designed to assess the value, reliability, and diagnostic utility of MRIs in preoperative planning in shoulder and knee surgery. Of those surveyed, 93% reported that there was believed to be a problem with the accuracy of an MRI in the setting of a prior surgery and/or if previous hardware was present specifically pertaining to the knee or shoulder. The most common indications of concern regarding knee or shoulder MRI reliability among this sample group were previous patient hardware (19%), a previous surgery (16%), and a chondral defect (11%). In addition, when asked how many MRIs were believed to be inconclusive based on previous surgery/hardware alone in the last 6 months of practice, an average of 19 inconclusive MRIs was reported. This study summarizes some of the concerns of MRI use in the orthopedic community and attempts to add a unique perspective on the attitudes, decision-making, and apparent economic problems that they face as well as uncover specific instances where MRIs were determined to be unreliable and incomplete in aiding the diagnosis and treatment algorithm.

【 授权许可】

CC BY   
© The Author(s) 2019

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