It is only natural if you have a problem to want to resort to some form of imaging to try to identify a cause. From a patients perspective this is understandable, for patients, it makes logical sense. Unfortunately, as with most things there is far more to consider here as we will go on to explain... Patients are misled by imaging so frequently that we feel it is very important to cover this topic early on.
ARE SCANS USEFUL?
Absolutely this is a yes, they are key to many things. This is not a one sided argument about the problems we encounter with misleading images however. Obviously scans are essential for surgical planning, identifying major/serious pathology, fractures, lesions and dislocations etc.
Will my scan ACCURATELY identify my problem?
It is very common for scans to show abnormalities that do not relate to a person's symptoms. These findings are often purely radiological incidental findings! Our clinicians interpret images in daily surgical clinics and constantly encounter these issues when analysing the hundreds of MRI and Ultrasound scans we come across a year. We find ourselves often explaining to patients why it is that their MRI scan shows a huge disc prolapse clearly compressing a nerve on the right side but yet their symptoms are only on the left!
FACTS AND FIGURES
48% of 20-22 year olds with absolutely no back pain or any issues had at least one degenerative disc seen on their scan, at least 25% had a disc bulge showing. (Source)
40% of individuals under the age of 30 and 90% of people over the age of 50 have disc degeneration, yet they are pain free. (Source)
One study found 98% of men and women with no neck pain had degenerative changes seen on their MRI scan. (Source)
SHOULDER ULTRASOUND SCANS
20% of pain free adults had a partial rotator cuff tear on MRI scan with 15% showing a major full thickness tear! For those people over 60, at least half have a rotator cuff tear they never even knew about. (Source)
If you x-ray a normal population of adults with no actual knee pain, at least 85% of the x-rays taken will show arthritis. (Source)
In one study, 48% of professional basketball players were shown to have cartilage damage on their knee MRI scans, none had any pain. (Source)
WHAT DO WE TAKE FROM THIS?
Degenerative changes are simply normal. What we see on our scans, often does not represent reality. There is no need to worry if your scan shows certain changes, they are not necessarily associated with pain. If you allow your images to mislead you, theoretically you could end up in higher amounts of pain for longer amounts of time.
Don't get us wrong, as previously mentioned, where appropriate, imaging is an important part of a patients care. Our clinicians at consortium rely upon images to make surgical decisions in conjunction with the surgeons we work with. What is essential is that a patients symptoms directly correlate with the symptoms that they present with. Both us, and patients need to make sure we do not get side tracked with purely incidental findings. Next time you somebody tells you that your discs are worn out or your shoulder is torn then I hope you can see there is no reason to immediately panic! It is absolutely feasible for patients with worn out joints to function at high levels with no symptoms.
The Consortium Team