Imaging in injuries: its uses and problems
Do you actually need that scan?
I must know, right now!!
The scourge of modern day life- instant answers wanted and required, like now, like right now!!!
When you're dealing with an injury, it's natural to want quick answers, know exactly what's going on and what to do about it. Perfectly reasonable requests really.
However with technology evolving it's getting easier and easier to access scans and imaging -sometimes when it's actually not needed- sometimes knowledge can do more harm than good- as they say ignorance is bliss....….
Medical imaging like X-rays, MRIs, and CT scans are often used to diagnose problems. While these can be extremely helpful in some cases, it’s important to understand their limitations—particularly when it comes to false positives and overdiagnosis.
It's a double edged sword here in NZ, unlike some countries, the process and ease of getting more technical scans (like CT, MRI scans) involves priority and wait times, and sometimes this can actually be a good thing (except when it's life threatening obviously).
So sometimes, guess what your injury improves, the pain goes away and turns out those scans aren't needed-(again take this with a pinch of salt).
But what can be the problem with scans, surely they're good? The more info, more power to make decisions.....?
Sounds great in theory......however, when are they not useful?
False positives - this can be a biggie.
A false positive is when the results of a scan shows an abnormality that may not be actually related to your symptoms or even be an actual injury.
For instance, an MRI might reveal a small tear in a tendon or a minor disc bulge in the spine, but these findings are often present in people with no pain or dysfunction.
Studies have shown that a significant percentage of adults have these "abnormalities" on scans, yet they experience no symptoms.
This becomes especially relevant as we age.
It’s common for spinal imaging to show changes like disc degeneration or bulging, but many of these findings are simply a normal part of aging and don’t necessarily indicate a problem.
The issue with this is that the mind can be tricky at times.
Once you're aware of something, you start focusing on it—and not in a good way.
'Oh no, I have a small tear in my knee cartilage—I must stop doing what I was doing,' when the reality is that it's been there for a while, you didn’t know about it, it caused no pain, and it didn’t affect your activity. But now, all of a sudden, you favour it, start doing less, and the decline gets worse
Overreliance on Imaging
One of the major pitfalls of imaging is that it can sometimes lead to overdiagnosis and unnecessary treatments.
Just because something shows up on a scan doesn't mean it's the cause of your pain or discomfort. Relying too heavily on these results can lead to invasive treatments like surgery or long-term medications that may not be necessary, when more conservative care like physio might be just as, or more, effective.
Context is Key
The most important thing to remember is that imaging results should always be interpreted in the context of your symptoms, medical history, and physical examination.
Imaging is just one piece of the puzzle. It’s often not enough on its own to determine the right treatment approach.
For example, a small disc bulge on an MRI might not be the source of your back pain, and addressing that issue alone could lead to ineffective or unnecessary treatment paths.
When Imaging is Useful
Despite its pitfalls, imaging can be incredibly valuable in certain situations.
For instance, in the case of traumatic injuries like fractures or significant ligament tears, imaging provides crucial insights that guide treatment.
However, for more common conditions like low back pain, tendon injuries, or age-related wear and tear, imaging may not change the course of care and can sometimes delay more effective treatments like rehabilitation or physiotherapy.
How to Avoid the Pitfalls of Imaging
Focus on Symptoms, Not Just Images: Work with your us or your GP/Specialist to determine if imaging is truly necessary. Not every injury requires a scan, especially if symptoms can be managed with physio treatment.
Avoid Overdiagnosis: Just because something abnormal appears on a scan doesn’t mean it needs to be treated. Again, it needs to be linked to any symptoms.
Stay Active and Informed: For aging adults, it’s important to remember that many changes in the spine seen on scans are a normal part of aging. Focus on staying active and maintaining mobility rather than worrying about every finding on an MRI or X-ray.
Trust the Rehabilitation Process: Exercise and physio, are often more effective at managing symptoms and improving function than relying solely on imaging and medical interventions.
In Conclusion
Righto: imaging like X-rays and MRIs can be helpful for diagnosing injuries or conditions, but they’re not perfect.
Sometimes, they show things that aren’t really a problem, leading to unnecessary treatments or stress.
It’s important to chat with us or your GP to understand what your imaging results really mean in the context of how you’re feeling and your overall health.
