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MRI after treatment

This week's question -

Why didn't my doctor order another MRI to see if I am healed after my treatment?

My answer -

This is a question I get often in patients who had surgical or non-surgical management of tears, spinal fractures, etc and I believe there are two factors in this answer.

The first one, is that if your condition was managed correctly, and you have returned to your activities without pain, having a follow up MRI will often do more harm than good. I often ask my patients "do you want a pretty MRI or do you want to be able to do _____ without pain? MRI's pick up all imperfections in our body, including those that are normal given our age, activity level, gender, heritage, etc. Sometimes these are picked up or described in more detail on one MRI report vs. another. If you have a follow up MRI, some "normal" changes may be seen, but once you know about them you can't "unknow" it. Have you ever left your house knowing you forgot to lock the door? And you are just sure that you are going to be robbed, even though a thief would have to come check your doorknob to even know it was unlocked? But once you know its unlocked, your brain tricks you into thinking something is wrong. Its the same with MRIs, if an MRI picks up something, it can change how you feel and give you fear and pain due to something inconsequential on an image. If you are feeling well and moving well, there is generally no need for a further MRI.

The second, and more frustrating reason for this is that insurance will not often pay for a follow up MRI unless there is reason to believe that whatever shows up on the MRI will require further intervention. MRIs are expensive and insurance companies don't like to pay out money. If this is the case, and you really want a further MRI you can ask your doctor to prescribe it and you can get it outside of insurance. PRO TIP - for imaging like MRIs many centers have a cash rate for unsinsured patients that is much more reasonable than what they are charging your insurance.

Hope this helps and gives you a perspective on why a follow up MRI is not common practice!

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