MRIs allow radiologists to peek inside our bodies and see tiny, detailed images of our organs and tissues.

The power of an MRI is no secret, but it seems to conjure up overblown expectations. Sometimes, the chief request of a patient in my office is “I need an MRI.”

Patients ask for an MRI with a sincere desire to understand what is causing their pain. Be it back pain, a swollen knee, or an aching shoulder, most will say, “I just want to know what’s wrong.”

So you can imagine a patient’s disappointment when I try to talk him out of getting that MRI. I do that not because MRIs are costly (although they are, about $1,200–$1,500 per scan) and not because I have anything to gain by denying the request. (I usually suffer greatly from the disappointment of saying no.)

But often, an MRI scan doesn’t really help.

SKEWED FINDINGS

I have long known that an MRI scan performed for muscle or joint pain often fails to pinpoint the exact cause of pain. The MRI can detect several anatomic abnormalities through amazingly detailed pictures, but exactly which one is causing the pain is simply a guessing game.

Don’t believe me? I would encourage you to read an article in The New York Times published Oct. 28. Several world-class orthopedic surgeons were interviewed for the story, which calls into question our appetite for MRIs.

The story describes how Dr. James Andrews—who has performed surgery for professional athletes such as Drew Brees, Roger Clemens, Michael Jordan and Jack Nicklaus—conducted a brilliant experiment.

His thought: What if he performed an MRI of the pitching shoulder of 31 professional baseball players? None of the 31 pitchers had any pain. All were elite athletes, playing at the top of their game. Yet an amazing 90 percent of those MRIs showed “abnormal” shoulder cartilage and 87 percent showed “abnormal” rotator cuff tendons.