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Jonathan Cluett, M.D.

Bone Spurs and Meniscus Tears Normal?

By September 1, 2012

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Knee MRIs are becoming increasingly common.  Some doctors are known to order these tests as a matter of routine for patients complaining of knee pain, and many patients expect to have an MRI if going to see the doctor.  But do MRIs help?  Well, it's complicated.  Many times MRIs can be helpful, but often they can be misleading.

A recent study looked at a group of middle-age to elderly patients who had knee MRIs.  They found that despite the majority of patients having no recent knee pain, almost all of the MRIs (89%) showed an "abnormality."  Many MRIs showed bone spurs, meniscus tears, and cartilage damage.

So what is normal, and what is abnormal?  Well, it takes a careful examination of the knee to know if what you are seeing on MRI corresponds the the symptoms of knee pain.  Not all abnormalities cause pain.  This same issue has been clearly identified in patients with MRIs of the spine.  Almost all MRIs of patients over the age of 20 show some abnormality including 'disc bulging.'  However, most of the patients have no symptoms of back pain.

Aging causes changes to the body. Hairs turn grey. Skin gets wrinkles. And a knee meniscus may tear. Is that a problem? Not always. In most cases, it's normal. Determining what is normal and what is not, is the challenging part, and it takes a skilled physician, not just an MRI test.

Doctors and patients need to better understand what tests are most appropriate, and when is the right time to get a test.  If your doctor doesn't recommend an MRI, it may not be because he isn't smart, in fact, you may have just found the smartest doctor...

Do you think MRIs are overused or underused? Leave your comments below...

Related: Do You Need an MRI?

Source: "Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study" BMJ 2012;345:e5339

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