There is no doubt that magnetic resonance imaging (MRI) is a unique technique to image the human body. The technique has brought a revolution in medicine and the rapid progress is still being made with an unsuspected potential of new developments with the ability to perform not only studies to see all the anatomy of the whole body, but also to analyse the activity of different organs of the body; as for instance detect the brain activity.
There is a growing number of MRI requests by doctors, due to the ability to have a proper picture of the human anatomy and detect promptly the disease suspected. Nevertheless, an imaging request and especially an MRI needs to be judicious and scrutinized by the physician who ordered it. It can be as dangerous as it is useful. Many patients view the MRI as a security blanket, and will go as far as requesting it.
There are numerous cases of diagnostic problems that result from misuse of the MRI. It is mandatory to perform a proper clinical correlation (making sure that what’s seen on MRI is in agreement with the patient’s problem) and the fact that any test including an MRI must be ordered to confirm a preliminary diagnosis that is already known from the history, exam, and more simple, inexpensive tests such as an x-ray.
“An MRI examination might show some findings, even pathological, but without any relation with the patient’s complaints. In this case there might be and overtreatment. That means treating an imaging finding but not what is causing the disease.”
At the end requesting an unnecessary test can lead to complications or excessive discomfort that might not have been needed. One of the most common examples is lumbar disk herniation. It can be found a protrusion or herniation on an MRI of the lumbar spine in 60% of the population without any complaints at all. Thereby, the risk is to treat the non-pathological disk disease; and what it could represent the potential consequences of a harmful surgical intervention.
At the end, requesting and MRI without a clear justification and especially without a proper doctor referral might cause more harm than benefit.