MRI not the gold standard

[LOL!]

I'm here in bed a few days after ankle surgery and reading what was done to my ankle. It was messed up way more than an MRI indicated and needed more repairs than I expected. The orthopedist had warned me, but I'm still bummed because rehab will be much more involved.

I had thought that the MRI would "see all" and had it done with a modern instrument in a reputable facility and "read" by a good radiologist, but the ortho was right, "We won't know everything until we go in there and actually look."

What's been your experience(s)? Have MRI scans been completely valid?

 

[bingybear]

I've only had one MRI. They were trying to determine the cause of some syncope. The radiologist noted all this damage noted in the MRI of my brain. The neurologist noted the noted the radiologist read it wrong and the brain was "beautiful", no issues.
From my experience the people interpreting the results were a bigger issue.

 

[splitwdw]

LOL, No experience with MRI's. Wish you a speedy recovery.


bingybear, You are so right, it's about the people interpreting the results.

 

[Dash man]

I've had multiple MRI's. One neurosurgeon was more than willing to perform a spinal fusion based on what he saw. Another neurosurgeon with better credentials determined surgery was not my best option, but to use pain management doctors instead because the nerve damage was too extensive in my cervical spine. I also had one of my brain that the neurologist determined actually did exist and appeared to look normal. Some people doubt that. Anyway, I've avoided surgery on my spine and pain management has worked well. Pain meds help between pain management procedures. I'm glad I avoided surgery since I've learned with many with similar conditions the pain comes back a year or two after the spinal fusion.

 

[jollystomper]

I can't complain. I had a cardiac MRI that helped them correctly find a heart defect that was causing an enlarged heart condition that put me at risk for pulmonary hypertension. I had surgery in time to "patch" the defect and avoided further issues. My heart is now back to normal size and my cardiovascular system is in great condition. So for me it was worth it.

 

[48Fire]

My wife had a bad break on her talus (ankle bone). Her MRI did not show everything, and the surgeon had to do a little more. Long recovery for her, and still has issues. Good luck to you

 

[MRG]

I've had multiple MRI's. One neurosurgeon was more than willing to perform a spinal fusion based on what he saw. Another neurosurgeon with better credentials determined surgery was not my best option, but to use pain management doctors instead because the nerve damage was too extensive in my cervical spine. I also had one of my brain that the neurologist determined actually did exist and appeared to look normal. Some people doubt that. Anyway, I've avoided surgery on my spine and pain management has worked well. Pain meds help between pain management procedures. I'm glad I avoided surgery since I've learned with many with similar conditions the pain comes back a year or two after the spinal fusion.

You stole my post..

The one neurosurgeon who insisted I needed surgeries also insisted on telling me how many ways he could kill or paralyze me. He also suggested MRI's distort up higher in the c-spine, we'll know more when......

I found other opinions.

 

[Alan]

I've had 5 MRIs on different joints and fortunately no surprises. The first 4 were prior to surgeries on knee, lower back and both shoulders, The 5th, and most recent on a shoulder, found that surgery was probably not necessary, and indeed a course of physical therapy was all that was needed to repair the micro-tears in the tendon. (Tendinosis)

Hope you get well soon.

 

[Rianne]

After my breast cancer dx 7 years ago, I went for a 2nd opinion in well known Chicago suburb hospital. Traveled out of state because of hospital's great reputation for cancer treatment. They proceeded with an MRI. The report showed high likely metastasis in liver and sternum. There were other nefarious spots. When my original BC surgeon saw this, she ordered bone scan, CT scan. Nothing like that showed up. Actually, I had surgery to remove it, did not have chemo or radiation and I'm cancer free (for now). That's my experience with an MRI.

 

[braumeister]

When I had hip problems a couple of years ago I got X-rays but when the doc saw them he pointed out a couple of things but said "We'll know for sure when we see the MRI."

Got an MRI and I agree it showed considerably more detail in the area where the X-ray showed less. But hardly night and day.

 

[Nemo2]

What's been your experience(s)? Have MRI scans been completely valid?

http://www.early-retirement.org/forums/f38/aneurysm-82778.html

Post #1 and Post #60 (and those in-between and after).

 

[Blueskies123]

See all? Did you get the MRI disk and look at the images? I have had 4 surgeries based on MRI results, one knee and three shoulder surgeries. They all said the injury was worse than the MRI showed.
MRI's are not all seeing, you are expecting too much from modern technology but it is still very good. It is no one's fault and you should not be bummed out. I think part of the problem is we all hear about 22 years old athletes that have access to all kind of expensive therapies making come backs in 6-8 weeks. Anyone over 40 let alone 60 like me has a year or more of recovery. I thank the Lord every day for surgeons, MRIs, and post operative pain killers.
Make sure you do all the physical therapy and do not way over use your foot for a year. Scar tissue tears easier than tendons.

 

[Major Tom]

LOL, No experience with MRI's. Wish you a speedy recovery.

Before I realized who the original poster is, this initially came across as a slightly insensitive reply I'm sure this is not the first time someone has thought that about a reply to LOL!

I've had 2 MRI's but cannot be of much help, as the results of the most recent didn't find anything untoward, and the other one was so long ago that I had already filed it in the section of my brain marked "previous medical procedures - discard exact details". I was glad that the first time I had one, the assistant warned me about the noise. He said it was going to sound like, "One of those techno-rave things". Not sure that was an accurate description, but it did help to prepare me. Like others here, I have always had the general impression that MRI's can reveal details that other tests don't necessarily show. However, the "we won't know exactly what we've got until we go in" line of thinking makes perfect sense in pretty much most situations.

 

[LOL!]

Thanks for all the responses. And Nemo2's link to their thread was disturbing, if not frightening.

My career involved helping to create scientific instruments similar to MRI devices. I named the OEM manufacturer of the MRI components making the noises which impressed the tech, "You're right, how do you know that?"

I also worked in a hospital at one point plus many close associates and family members are physicians. I realized a long time ago that they are fallible, so I kinda expected the responses. Doctors don't like it when I question their opinions.

It's always trust, but verify.

 

[Amethyst]

My reaction (standing in the MRI room with Mr. A, who was in the machine) was that it did indeed sound like techno-electronic "music." It is very loud (they give you ear plugs which help a little bit). There are many different notes, highly syncopated, but the pattern seems random (although I'm sure it's highly programmed).

Also, each new measurement begins with a series of strident percussive tones, followed by a dramatic pause. Mr. A. was expecting to be bored and impatient with having to stay completely still for so long, but he said afterward that he got wrapped up in trying to figure out what sounds were coming next.

I was glad that the first time I had one, the assistant warned me about the noise. He said it was going to sound like, "One of those techno-rave things". .

 

[RunningBum]

I had a similar experience as the OP had, with my knee a few years ago. MRI showed ACL and MCL tears, but doc warned me he might have to work on the meniscus too once he got in there. Sure enough, he had to repair it, which was no big deal long term but kept me on crutches longer short term.


I think you set yourself up for disappointment. The doc warned you this might happen, yet you didn't prepare yourself for a worse outcome. I understand being bummed, and I was too, but you seem to feel like you were misled, which you aren't. You ask if others have found the MRI to be completely valid, when it was never presented to you as being so. I don't mean that to be harsh, but it does seem to be the reality of both of our situations.

 

[Alan]

My reaction (standing in the MRI room with Mr. A, who was in the machine) was that it did indeed sound like techno-electronic "music." It is very loud (they give you ear plugs which help a little bit). There are many different notes, highly syncopated, but the pattern seems random (although I'm sure it's highly programmed).

Also, each new measurement begins with a series of strident percussive tones, followed by a dramatic pause. Mr. A. was expecting to be bored and impatient with having to stay completely still for so long, but he said afterward that he got wrapped up in trying to figure out what sounds were coming next.

I actually fell asleep during my last MRI, woke up with a panicked technician calling my name over the speaker inside the tube.

 

[MRG]

I actually fell asleep during my last MRI, woke up with a panicked technician calling my name over the speaker inside the tube.

My last MRI was a tragic accident. My c-spine was causing incredible pain and numbness in my left arm. As the tech got me situated that nerve got pinched and as the tech gave me the panic button in my left hand it became paralyzed.

So here I am in the MRI in incredible pain and a panic button I can't depress! Somewhere during the event the tech uses the speaker to tell me to stay still! Haha, I'd been screaming in intense pain for at least 20 minutes! They said the MRI was OK quality wise, as after it was over I let them know how much I'd been moving around.

 

[Alan]

My last MRI was a tragic accident. My c-spine was causing incredible pain and numbness in my left arm. As the tech got me situated that nerve got pinched and as the tech gave me the panic button in my left hand it became paralyzed.

So here I am in the MRI in incredible pain and a panic button I can't depress! Somewhere during the event the tech uses the speaker to tell me to stay still! Haha, I'd been screaming in intense pain for at least 20 minutes! They said the MRI was OK quality wise, as after it was over I let them know how much I'd been moving around.

Wow, that was some experience.

 

[Just_Steve]

Last MRI was a 3T MRI which eliminated the need of an endorectal coil that would be needed with an older 1.5T MRI.
And trust me an endorectal coil is as unappealing as it sounds.

 

[Texas Proud]

I have been reading this thread and just kinda taking things in...


But it downed on me... the thread title is slightly wrong IMO... an MRI is the 'gold standard' since there is nothing better that I know of... it might not be to a point where you can see every detail etc., but I do not know what is except for cutting someone open...

 

[LOL!]

@TexasProud, yes, I agree with you. Although this was my 6th full-anesthesia orthopedic surgery (I'm an active guy) in my life, it was my first MRI experience.

The experiences of responders have all been interesting. I apologize to RunningBum for my opioid-induced whining.

And thanks for the well wishes everyone. I am sure I will recover well. I always have.

 

[RunningBum]

The experiences of responders have all been interesting. I apologize to RunningBum for my opioid-induced whining.

Ha! Didn't think about the fact that you may still be on painkillers! Best of luck with the recovery, and good for you for staying active. So far just one such surgery for me. Wish I had video of the ski wreck, I'm told it was awesome, about a 320 degree backflip on skis. 360 would've been a lot better...

 

[oldphd]

I'm not an MD, but my PhD dissertation was related to MRI (more about the machinery and ancillary equipment). In the course of that, I needed to learn the basics of how they work. Just a few comments here.

MRI is able to image soft tissue in ways that other procedures simply can't.

There are different coils and many imaging protocols, and they are selected based on what is being looked for. IOW, you have to have an idea of what you're looking for when planning the MRI. An imaging protocol used for detecting minute breast cancer is different than one looking for a torn ligament is different than one looking at brain function. Aside from scanning protocols another variable to add is contrast. LOTS of variables!!!

This may be a poor analogy, but I'll try for something simple. You broke your ankle and went for an Xray, but they took an Xray of your wrist and said you were fine. But you DID break your ankle and now arrive at the conclusion that X-rays are worthless.

The scanning sequence selection and subsequent reading of the results is highly specialized. A good operator and radiologist can make a difference.

One last thought on the noise generated. This is a function of the static field strength and imaging protocol. Lots of variables again. One person may experience something not too loud, while another experiences something way louder. Or one is continuous and another has an on/off trait. Different people may have vastly different experiences while undergoing imaging.

 

[Rianne]

I totally believe your expertise, but if I believed the MRI report after my BC dx (it was at Cardinal Bernadine Cancer Center, Loyola Medical Center in Maywood, IL), I would have lost my marbles. For some reason, that report just seemed impossible to me. My BC surgeon did the CT and bone scans and none of the report was accurate. Maybe the radiologist read the report wrong or read some else results. To say the cancer had likely metastasized to my sternum and liver? I actually had a 1 mm lesion in my breast with DCIS. Honestly, that was all. I completely understand there are mistakes in the medical profession, we are human, after all. Just saying, that was my experience with MRI. I would like an explanation why CT and bone scans are more accurate in this situation.