A couple of articles have surfaced recently which raise more questions on the usefulness of medical scans. Now, don’t get me wrong, they are useful. What we’re talking about here is whether they are used too often (knowing the radiation risk), and whether the findings on scans are as important as they’re made out to be.

I’ve written on this before when I talked about how the findings of serious structural change on CT scans had no correlation to pain, and the first study I’m going to talk about pretty much echoes that sentiment. A study presented at the American Orthopaedic Society for Sports Medicine’s Specialty Day in New Orleans (which was held on March 13 if you want to bookmark it for next year, I imagine it’s a real hoot) found that 70% of healthy hockey players of Professional and Collegiate level had abnormal findings on MRI (that is, they had problems), even though they had no symptoms of injury.

According to the authors, “This study might make you hesitate to read too much into an MRI.” You got that right. The most amazing finding to me was that 54% of the players had labral tears! For those who don’t know what that is, it’s a pretty significant problem. Or so I thought, turns out maybe it isn’t. Only 2 of the players in the study had “slight pain”.

If knowing that the findings of these scans are potentially irrelevant wasn’t enough to deter you, maybe the news that they are being over-prescribed and that the radiation poses a cancer risk might. The Australian reported that medical authorities are alarmed at the increasing rate of unnecessary CT scans.

Some doctors just routinely order them for anyone who comes in with back pain. When I was at University, we were taught that the incidence of serious structural pathology was less than 1%, so you certainly wouldn’t scan (and expose to unnecessary radiation) 100% of patients.

The other problem was that patients are not routinely made aware of the risks. For example, an abdominal CT scan floods your reproductive organs with 800 times the radiation emitted by a simple X-ray.

The suggestion was made that sometimes patients insist on scans because they think they are “the best thing since sliced bread”. In summary “patients need to be educated that these things have a place but not without due consideration.”

More Stats from The Australian:

• Re CT scans for children: “ the risk of a single scan triggering a fatal cancer is 70 times greater than the chance of dying from a general anaesthetic.”
• the risks of CT scans for young people up to the age of 20 are much higher than for adults
• CT body scans were so strong that one in every 500 babies under the age of 12 months subjected to the procedure could be expected to develop a fatal cancer in later life