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MRI Utility in Hand Surgery
Journal article   Open access   Peer reviewed

MRI Utility in Hand Surgery

Michael J DeFrance, Kevin F Lutsky, Asif M Ilyas and Jonas L Matzon
Hand (New York, N.Y.), v 16(3), pp 298-302
01 May 2021
DOI: https://doi.org/10.1177/1558944719861725
PMID: 31288574
url
https://doi.org/10.1177/1558944719861725View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Fractures, Bone Hand - diagnostic imaging Hand - surgery Humans Magnetic Resonance Imaging Scaphoid Bone - diagnostic imaging Scaphoid Bone - surgery Wrist Injuries
Magnetic resonance imaging (MRI) is frequently used in the diagnosis of upper extremity conditions. We hypothesize that the results often do not change treatment. The purpose of the present study was to prospectively assess the extent to which MRI findings alter patient management. Ten hand surgeons who were ordering an MRI (elbow or distal) completed a standardized questionnaire. Prior to obtaining the MRI, the surgeon recorded their pre-MRI diagnosis and recommended treatment if no MRI could be obtained. Following the MRI, the surgeon recorded their post-MRI diagnosis and ultimate treatment recommendation. Finally, the surgeon answered whether the MRI was helpful, and if so, how it helped guide their treatment. Descriptive statistics were performed. One hundred eighty-seven MRIs were ordered. The most common reasons for ordering an MRI were the evaluation of presumed occult scaphoid fracture, ulnar wrist pain, metacarpophalangeal joint collateral ligament injury, and mass. The surgeon agreed with the radiologist's interpretation of the MRI in 88% of cases. Overall, surgeons found the MRI to be helpful in 92% of cases, and the recommended treatment changed as a result of the MRI findings in 19% (35/187) of patients. Of these 35 patients, 9 had a pre-MRI diagnosis that was concordant with the MRI findings, but the proposed management of the patient changed after the MRI. Hand surgeons infrequently change their treatment plan based on MRI findings. Given the importance of cost-efficient care, indications for use of MRI may need to be re-evaluated.

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Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
Surgery
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