There is commonly the thought that obtaining an MRI before your visit will "Save a step" in getting you better. What I frequently tell patients is that "I treat people, not MRIs". What that means is that I am far more interested in what you have to say and what your knee feels like, than what an MRI can tell me about your knee. So, getting an MRI may be necessary at some point, but may not be necessary.
MRIs also come in different varieties and I order special MRI sequences depending on the question I want answered. For example, if I suspect a SLAP tear in a young pitcher I will order dye injected into the shoulder joint prior to the MRI, making it an MR arthrogram. I will also request that their arm be placed in a certain position. I will not typically ask for an MR arthrogam in a 50 year old carpenter with shoulder pain in which I suspect a rotator cuff tear. If a patient has had previous surgery, metallic anchors would make an MRI useless because the metal would interfere with the magnets and the picture would be blurry. In that case, a CAT scan with dye injected into the shoulder would be a more useful way to see the structure of the shoulder.
The final reason not to try to get an MRI before you see me is that most primary care doctors have difficulty convincing your insurance that they should pay for an MRI. Their staff has to argue and struggle with the insurance companies to get the MRI "pre-approved". Frequently, despite all of their efforts, the insurance companies feel that the MRI is not warranted. Our office, on the other hand has a near flawless record of getting these approved. Part of this is my wonderful staff and their familiarity with the nuances of MRI scheduling and part of it is that for better or worse, my recommendation as a specialist carries more weight with the insurance companies than your PCP. So, let us do the work for you and save yourself the aggravation.
- J. Fallon
