Inappropriate requests for magnetic resonance scans of the shoulder

摘要

Purpose: Magnetic resonance imaging (MRI) scans are a useful investigation for some shoulder pathology. They are costly however and a significant burden on radiology departments. In most cases clinical examination, plain radiography or ultrasound scan (USS) are sufficient for a diagnosis. There are no current UK guidelines regarding MRI shoulder scan requests. Methods: We reviewed 100 consecutive MRI shoulder scan requests and the associated formal reports; other investigations were also assessed. Results: Overall, 56 % of MRI scans were ordered inappropriately. Shoulder consultant's requests were more appropriate than other groups (70 % vs. 38 %. p = 0.04). Excluding shoulder consultants 63 % of scans were inappropriately ordered. Shoulder consultants were more likely to order a preceding X-ray (80 % vs. 53 % respectively, p = 0.03). Of those with a clinical diagnosis of cuff pathology only 29 % had an USS. Conclusion: A high percentage of MRI shoulder scans are performed inappropriately. Shoulder consultants are more appropriate in their ordering than other groups. If all groups performed as well 50 % less MRI scans would need to be performed.