Knee pain is common among Americans age 40 and up. Nearly 1 in 17 people visit doctor offices each year for knee pain or injuries for osteoarthritis – a progressive “wear and tear” diseases of the joints.

Those odds increase as the U.S. population continues to age and becomes even more overweight. While an Magnetic Resonance Imaging (MRI) exam is one tool that can help doctors diagnose torn knee ligaments and cartilage and other problems, plan x-rays are the best first line screening tools for knee pain.

According to a study in the September 2016 issue of the Journal of American Academy of Orthopaedic Surgeons (JAAOS), a simple x-ray is frequently the best diagnostic tool, reducing both time and cost.

The study looked at 100 MRI exams of knees from patients age 40 and up and found the following:

  • The most common diagnoses are osteoarthritis (39%) and meniscal tears (29%), a tear of the wedge-shaped piece of cartilage in the knee joint.
  • Nearly one in four MRI exams was taken prior to the patient’s first having obtained a weight-bearing x-ray.
  • Only half of the MRI exams obtained prior to meeting with an orthopaedic surgeons actually contributed to a patient’s diagnosis and treatment for osteoarthritis.

Researchers recommend that people should always get weight-bearing x-rays before getting an MRI because an MRI is not always needed to diagnose knee problems. In cases where arthritis suspected, weight-bearing x-rays often are more than enough for orthopaedists to complete the diagnosis and treatment plan. An appropriately timed consultation with an orthopaedic surgeon can be more cost effective than first obtaining MRI scans.

It is appropriate to note that the American College of Radiology issued and continues to update imaging appropriateness criteria for physicians and other health care providers. In the area of non-traumatic knee pain, in all cases, the first recommended procedure is an x-ray. MRI is strongly recommended only after x-rays have been taken and x-rays proved inconclusive or did not show any injury.

MRI is a far superior exam in identifying areas of concern joints such as knees, hips, elbows, ankles and shoulders that do not show on x-rays.

In many cases, an appointment for an x-ray is not necessary. Contact the appropriate Capitol Imaging Services center for further information. Capitol Imaging Services is doctor trusted and patient preferred.

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