My father used to say when he wanted to dismiss the importance of something that you could get that thing and a cup of coffee for a nickel. So it is with Knee MRI findings this morning. I have written many times in this blog that we have an entire medical system peering at MRI images like they were the Oracle of Delphi incarnate, yet research study after research study questions whether pain and MRI findings have anything to with each other. Yes, you read that right, your knee MRI report may well be worth about the same amount as a sandwich and a cup of coffee in the 1940’s. So here’s another study. This one is also by the same Framingham group that showed us that knee meniscus tears on MRI are found as often in middle aged or elderly people with pain as without pain. Their conclusion in this study? “The prevalence of at least one type of pathology (“any abnormality”) was high in both painful (90-97%, depending on pain definition) and painless (86-88%) knees.” Translation? An abnormal knee MRI not significant and was just about as likely to be found in patients with pain as patients without pain. So what’s causing your knee pain? Well it may be caused by some of the things on your knee MRI or it may be nerve related. However, what these studies tell us is that looking at your MRI and performing a cursory 2 minute exam isn’t enough for us to conclude that the pain is actually coming from your knee. It’s also certainly not enough to base an invasive surgery. If you want to know more about why you hurt and what might help, read our practice’s e-book, Orthopedics 2.0.
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About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…