'

MRI scans are too routine

A single scan can cost $750-1,000 and if it turns up something wrong surgery is often ordered routinely. Diagnosing based on pain, and considering surgery only after a period of rest, can save both scans and surgical suites.

MRI from the Nobel Prize siteIt must be the most common sports story of all. An athlete hurts so they have an MRI diagnose what is wrong.

(Paul Lauterbur and Peter Mansfield shared the 2003 Nobel Prize in Medicine for their work with MRIs. From the Nobel Prize site.)

Just take a quick look at today's sports headlines:

  • An MRI confirmed Stephen Jackson of the Golden State Warriors has a sprained hand.
  • Adam "Pacman" Jones of the Dallas Cowboys could play again this season despite a pain in the neck. His first statement after feeling the pain -- I need an MRI.
  • Josh Howard of the Dallas Mavericks doesn't know when he will be back after repeated MRIs failed to find what is wrong with his foot.
  • Duane Culpepper of the Detroit Lions had an MRI on his shoulder, and doesn't know if he'll be back this year.
  • Cuttino Mobley of the New York Knicks retired after an MRI showed a thickening of his heart muscle. Subsequent exams revealed hypertrophic cardiomyopathy. "The MRI saved my life," he said.

In all these cases MRIs were used for diagnosis. It's routine.

Should it be?

In a September article in the New England Journal of Medicine, David Felson and others at the Boston University College of Medicine found MRIs on aging knees often diagnose minescus tears that are perfectly normal.

A study at the Cleveland Clinic found similar results regarding bad backs. Dr. Michael Modic, who heads the clinic's Neurological Institute, concluded MRIs are pre-surgical tools, not diagnostic tools.

A single scan can cost $750-1,000 and if it turns up something wrong surgery is often ordered routinely. Diagnosing based on pain, and considering surgery only after a period of rest, can save both scans and surgical suites.

What about the jocks? Mobley was right to have an MRI and Pacman (as usual) was wrong. And if we stop making snap decisions based on MRIs we can save billions of dollars each year.