Don’t order a knee MRI when weight-bearing x-rays demonstrate osteoarthritis and symptoms are suggestive of osteoarthritis as the MRI rarely adds useful information to guide diagnosis or treatment.

The diagnosis of knee osteoarthritis can be effectively made based upon the patient’s history, physical examination, and plain radiography consisting of weight-bearing posterior-anterior, lateral and skyline views. Ordering MRI scans incurs further waiting times for patients, can cause unnecessary anxiety while waiting for specialist consultation, and can delay MRI imaging for appropriate patients.

Sources:

Menashe L, et al. The diagnostic performance of MRI in osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2012 Jan;20(1):13-21. PMID: 22044841.

Sakellariou G, et al. EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis. Ann Rheum Dis. 2017 Sep;76(9):1484-1494. PMID: 28389554. https://www.ncbi.nlm.nih.gov/pubmed/28389554

Zhang W, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis. 2010 Mar;69(3):483-9. PMID: 19762361. https://www.ncbi.nlm.nih.gov/pubmed/19762361