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When To Seek Medical Imaging

Method Health
Oct 30
13 min read

Updated: 18 hours ago

Here are our best resources to help you decide whether to seek imaging for your concerns after you have been given a diagnosis as an adult. You might have had this discussion with our coaches already, whether to justify imaging (and surgery) or not, so here is the evidence for our input. 


Why not seek imaging for everything? Generally, imaging is helpful only if bracing/casting, surgery, injections, or a change in medical management, such as a change in medications, is likely to be more effective than non-invasive, exercise-based management. Seeking imaging outside of this context, often to just “find the cause of pain,” often has more long-term harms than benefits for your health. As ethical health care professionals, it is within our duty of care to not encourage seeking imaging too “early” as we have clear evidence this can be harmful to you in the long term, despite the promise of reassurance (Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care + Iatrogenic Consequences of Early Magnetic Resonance Imaging in Acute, Work-Related, Disabling Low Back Pain + Incidentalomas, SPEW, and VOMIT—radiological dyspepsia? + The catastrophization effects of an MRI report on the patient and surgeon and the benefits of ‘clinical reporting’ + Does Rewording MRI Reports Improve Patient Understanding and Emotional Response to a Clinical Report?). We strongly encourage that “before you scan, have a plan” as we will always support the “wo/man not the scan.”


Be informed of the normal, healthy aging appropriate findings that can mistakenly be labelled or believed as “abnormal” (EBP Podcast Back pain fact with patient voice, Joe - 'Scans rarely show the cause of pain' + Physical Therapist Debunks 5 Most Common Myths About MRIs & X-Rays + Imaging Myths - E3 Rehab + RACGP - Towards appropriate imaging: Tips for practice + To Image or not to Image | Andrew Cuff | Ep. 052 + Gurpreet Singh - Discussing when a scan may be useful + Ben Whybrow "“So can I have an MRI?” - A frequent but difficult conversation in MSK ACR Appropriateness Criteria + Base Rates Across Common MSK Imaging Findings. What are normal but labelled mistakenly as “abnormal” imaging - Google Docs + Structure is not Destiny - please don't rush to freaking out about your x-ray, MRI or ultrasound — Greg Lehman). Also you should be informed of what “normal” symptoms recovery is for many concerns people are seeking imaging for due to expectation that “this should still be symptomatic (Talking About Natural History- The NAF Physio Podcast - Apple + Prognosis / Natural History - Google Docs).


So here is our reasoning for encouraging seeking imaging for the common areas in the body.


Body region (Click on a heading to skip to it's section):


Neck and Mid Back

Symptoms post-high sudden trauma from a car accident, fall, or sports injury, or nerve-related pain, numbness, or weakness worsening within weeks around the neck, shoulder, arm, and hand. When these symptoms occur spontaneously or gradually over days, a visit with a healthcare practitioner to confirm the need or lack of need for imaging is advised. Pain is not often the most important concerning feature. 


Low Back

Symptoms after a car accident, fall, or sports injury, or present with nerve-related leg pain, numbness, or weakness worsening within weeks around the hip, knee and/or ankle. Pain is not often the most important concerning feature. 


Knee 

Symptoms with swelling within hours after a fall or high speed knee twisting action warrant further assessment but some conditions presenting like this still might not need imaging to manage well


Hip

Symptoms after a fall, car accident warrant further assessment but some conditions presenting like this still might not need imaging to manage well


Hamstring



Shoulder


Calf/Achilles

Suspected calf strain Imaging is not recommended for helping manage calf muscle strains Method Health- Muscle Strains and Exercise 


  Ankle/Foot


Elbow

Imaging can be helpful to plan the need for elbow bracing +/- surgery after a fall onto your elbow or outstretched arm


Wrist/Fingers



 
 
 

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