After teaming up with InHealth Specialist Imaging Centre I’m very pleased to announce that I can now offer Private MRI Referrals, with the actual MRI procedure usually being undertaken within just two days of my referral.
If we (you and I) decide that an MRI scan is the best way forward, I’ll fill out all the necessary paperwork including a succinct summary of your medical history and a preliminary diagnosis for the InHealth radiologist. A member of the InHealth administration team will then contact you directly to arrange a suitable appointment day/time and to discuss payment options. This service is unfortunately not available via the NHS and payment for the MRI will have to be met by yourself, or your Private Medical Insurance, but the referral will no longer have to be via your GP so there will be no long delays!
MRI scan within 48 hours, written report within 4 days
Following the scan, the InHealth Consultant will examine the images and produce a written report which will be sent directly to me within 2-4 days of the scan taking place, again, reducing waiting times and negating the need for another GP appointment.
The MRI scan itself will take place at the Nottingham Specialist Imaging Centre within the Nottingham City Hospital complex. On the day, the skilled staff at InHealth will handle the whole process for you, giving you personalised care for the most comfortable experience possible.
Once I receive the report, I will arrange for you to pop in to discuss the findings and plan for your ongoing care.
MRI’s are still the Gold Standard imaging technique for
helping with the diagnosis of most musculoskeletal problems
So, does this mean I’ll be recommending an MRI scan for every patient from now on? Very unlikely. Whilst MRI scans are still the Gold Standard imaging technique for helping with the diagnosis of most musculoskeletal problems, the correlation between MRI findings and back pain in particular, is at best, mediocre.
In fact, not only are the majority of MRI findings not helpful, several studies show that the incidental findings of many MRI’s are actually harmful to the patient from a psychological perspective. Reports revealing disc bulges and degenerative discs lead to a change in the patient’s behaviour, often exacerbating the original condition through fear of exercise and movement. The ambiguous findings of wear and tear, which may or may not have any relevance at all to the patient’s pain, often lead to further unnecessary tests and medical consultations, adding to the fear of movement, exercise and work.
MRI’s findings of healthy people and those who have
suffered a whiplash injury show similar results
This is just a brief account of what some of the research tells us;
Cervical spine (Neck)
One MRI study of healthy adults and seniors, experiencing no neck pain found that a whopping 98% had evidence of degenerative changes in their cervical discs. In another study of healthy, pain-free, young adults, 78% showed evidence of disc bulges. Another interesting study comparing the MRI’s of healthy people with those who had suffered from whiplash, both immediately after injury and 10 years later, found both groups had similar MRI findings with 75% having neck disc bulges.
Thoracic Spine (Mid Back)
Two studies of healthy adults with no history of back pain, found that 47% had disc degeneration, 53% had disc bulges and 58% had disc tears in their thoracic spine. Remarkably, 29% of these healthy adults had a disc bulge that was pressing on and deforming the spinal cord, and yet they had no symptoms!
Lumbar Spine (Lower Back)
A large study of over 1000 individuals showed that lumbar disc degeneration was present in 40% of those under the age of 30 and over 90% in those aged 50 to 55. In another study of over 500 young adults aged 20-22 years experiencing no back pain, 48% had at least one degenerated disc, and 25% had a bulging disc.
MRI findings of degenerated discs and disc bulges are
perfectly normal from the age of 20 onwards
In conclusion; MRI findings of degenerated discs and disc bulges are quite normal from the age of 20 onwards. In fact, as much part of the ageing process as grey hair, wrinkles and wisdom!
There is no linear relationship between scan discovered changes and pain. Pain, even severe pain, may be present with mild or even no scan changes, whilst severe scan changes may exist with absolutely no pain. So, if there is pain and there is MRI evidence of degeneration or disc bulges, it still doesn’t automatically mean that the changes seen on the scan are the cause of your pain!
The National Institute for Health and Care Excellence (NICE) Guidelines for Low back pain and sciatica in over 16's: recommend imaging should only be considered in specialist settings; if the result of the MRI is likely to change the management.
MRI scans are an important tool that doctors have at their disposal, an imaging technique that would have been the envy of their forebears. They can help confirm the presence or absence of a disease or an injury. They provide very detailed diagnostic pictures of the important organs and tissues in your body and are sometimes able to show unique information that other tests are unable to show. They are generally painless, do not use radiation and are therefore suitable for use in children and during pregnancy.
However, the diagnosis of any condition requires more than a single examination or test. An MRI scan should always be used to supplement, and not replace, the medical history and clinical findings.