MRIs for Sports Injuries Can Lead to Overtreatment

It’s natural to want an X-ray or MRI or some other kind of scan when you’ve had an injury that’s so painful it hurts to use the involved body part. But many orthopedic surgeons are starting to speak out against the overuse of MRI scans in particular. They say it leads to over-diagnosis of injury and too much surgery on patients who don’t need it.

To prove the point, orthopedist James Andrews did MRI scans on the shoulders of thirty-one professional baseball pitchers. Nine out of ten resulted in readings of abnormal shoulder cartilage, according to an article by the New York Times’ Gina Kolata, who frequently writes about sports injuries and their treatment. Dr. Andrews’ lesson: “If you want an excuse to operate on a pitcher’s throwing shoulder, just get an M.R.I.”

The article also has a fascinating cautionary tale about a patient named Steve Ganobcik, who twisted his knee skiing, but was able to keep skiing for two more days on his vacation. He then underwent an MRI scan when the pain didn’t go away. The orthopedic surgeon told him he had a torn ACL ligament in the knee and needed surgery. After two second opinion consultations, he discovered he had no torn ligament at all but a subtle fracture in one of his shin bones that needed no surgery.

The surgeon who steered him straight had his suspicions raised by Mr. Ganobcik’s story. He could never have continued skiing with a torn A.C.L. The diagnosis “made no sense,” said Dr. Freddie Fu, chief of sports medicine at the University of Pittsburgh Medical Center.

This proves once again that the patient’s story, as listened to by a careful and conservative doctor, can be the best guide to treatment.

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