All MRIs Are Not Created Equal

Jan. 25, 2009 — -- The pain in Katie Vincent's leg was so severe, she begged doctors to give her an MRI. It began in December 2007. She visited the urgent care in her hometown of Longview, Wash., north of Portland, Oregon. Each time, she was sent home with painkillers, which provided little relief.

"It was just constant," said Katie. "It didn't matter whether I was sitting, laying, not even on my leg, it was just a throbbing, achy horrible pain."

Doctors told her it was probably a ski injury, and that since she was only 24 years old, it would likely improve. When it didn't, Katie limped back to the hospital on crutches, to beg someone to give her an MRI. They finally agreed to do the scan, however Katie and her family were shocked to learn that the reading came back normal.

Maxine Vincent, Katie's mother, was in the room. "I couldn't believe they were saying it's normal because I know her. She's really strong, and she couldn't function. "

Dictation on the MRI showed a normal reading, and the doctor there suggested she see an orthopedist. However, getting an appointment when she had a normal reading on her MRI proved to be very difficult. Most doctors wanted her to wait weeks.

But Dr. John Kretzler, an orthopedist with the Pacific Surgical Institute in Longview, agreed to see her. He knew immediately that her MRI was anything but normal. "The initial reading of the MRI made no comment as to whether there was an abnormality in her femur," Kretzler said. "I wasn't comfortable with the way it looked. With her pain and the way she was presenting, I thought something was going on. I was surprised there was no comment as to what the bone looked like." Katie said when Dr. Kretzler touched her leg with the littlest amount of pressure, she nearly jumped off the table. Kretzler informed her that her MRI was misread.

"He threw out a bunch of words like lymphoma, benign tumor," said Katie. "And to know they missed it, it was a horrible feeling."

While Katie finally had a sense of what might be wrong, she ran into another roadblock. Before she could see a cancer specialist recommended by Kretzler, she first had to undo the faulty MRI reading. Her insurance company was unwilling to cover further treatment, until the MRI dictation was changed.

Is the doctor sub-specialized and fellowship-trained in the area of the body your MRI is for? If you don't feel good about the radiologist's background, you could always have your images sent via mail, e-mail or on CD to a more specialized doctor.

For more information on MRI's go to Radiology Info, sponsored by ACR and the Radiological Society of North America, at radiologyinfo.org and the International Society for Magnetic Resonance in Medicine's web site at ismrm.org.