When the MRI lies

SPINAL EDUCATION

When the MRI Lies

Magnetic resonance imaging is the single greatest advancement in the diagnosis of spinal pathology since the introduction of x-ray by Wilhelm Röntgen in 1895.6 MRI provides the clinician with a precise picture of the pathologic anatomy of the spine.2,4,5,7 The technique has been maligned because of its lack of specificity particularly in patients over 60 where up to a 57% false-positive rate has been reported.1 This should not come as a surprise since we have known for years that the clinical symptoms of acute disc herniation and spinal stenosis can be transient leaving the patient with a demonstrable pathologic lesion asymptomatic.3 It is up to the clinician, not the radiologist, nor the MRI scanner, to decide whether the anatomic lesion discovered by the test is clinically significant.1,8

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