ArticleCanadian family physician Medecin de famille canadien2018
Indications for and clinical procedures resulting from magnetic resonance imaging of the knee in older patients: Are we choosing wisely?
Article in Canadian family physician Medecin de famille canadien, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 12 citations in OpenAlex.
- Temporal and geographical variations in musculoskeletal imaging: a register-based study in Norway with focus on potential low-value imaging.Research in health services & regions · 2025Article
- Does MRI alter management in patients 60 years and older with chronic knee pain: correlation with radiographs and clinical parameters.Skeletal radiology · 2024Article
- Is Magnetic Resonance Imaging Overused Among Patients Undergoing Total Knee Arthroplasty?Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
- Article
- "You're stuck in the middle here": a qualitative study of GPs' experiences of managing knee pain attributed to a degenerative meniscal tear.BMC primary care · 2023Article
- Protocol for the Request of Knee Magnetic Resonance Imaging in Elderly Patients with Suspected Osteoarthritis: Reduction in Test Requests and Impact on Management and Diagnosis.Revista brasileira de ortopedia · 2022Article
- Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review.BMC medical imaging · 2022Article
- Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis - are we using appropriate imaging?Journal of experimental orthopaedics · 2022Article
- Preferences and beliefs of Dutch orthopaedic surgeons and patients reduce the implementation of "Choosing Wisely" recommendations in degenerative knee disease.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo analyze the indications for and clinical procedures resulting from knee magnetic resonance imaging (MRI) in older patients.
designWe retrospectively analyzed 215 medical records of patients 50 years of age and older who had undergone a unilateral knee MRI in 2009.
settingCentre hospitalier universitaire de Sherbrooke in Quebec.
participantsPatients 50 years of age and older who underwent a knee MRI in 2009.
main outcome measuresThe main outcome measure was an invasive procedure in the same knee that underwent an MRI. Medical charts were reviewed up to 2014 for patient characteristics, MRI indication, ordering physician specialty, radiography before MRI, MRI findings, and clinical procedures resulting from the MRI.
resultsThe patients' mean (SD) age was 60.6 (7.5) years. The main MRI indications were meniscopathy (148 [68.8%]) and chronic pain (92 [42.8%]). The main MRI findings were osteoarthritis (OA) (185 [86.0%]) and meniscal lesions (170 [79.1%]). Only 82 (38.1%) patients had a plain radiograph in the 24 months preceding the MRI, usually without a standing anteroposterior view. Findings on pre-MRI radiography (n = 201) demonstrated OA in 144 (71.6%) patients. Overall, 87 (40.5%) patients were seen by an orthopedic surgeon and 27 (31.0%) of these patients underwent an invasive intervention. Among the 81 patients with moderate to severe OA on MRI, 36 (44.4%) had radiographic evidence of moderate to severe OA and only 3 (3.7%) underwent arthroscopic meniscectomy.
conclusionOur study reproduces the known association between OA and degenerative meniscal changes in older patients. We have found a surprising underuse of the standing anteroposterior view on radiography. Most patients in our cohort could have been appropriately diagnosed and treated based on such radiographic information, as demonstrated by pre-MRI findings, thus avoiding the MRI and subsequent evaluation by an orthopedic surgeon. Meniscectomy was rarely performed, particularly in patients with advanced OA. Educational and pragmatic measures must be emphasized to encourage the use of radiography and to limit the inappropriate use of MRI, a costly technique.
Indexed as
Identifiers
29540401PMC5851409W2792284869What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.