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Seven points to consider about MRI testing:

1. Sixty four percent of patients with no history of back pain had abnormal MRI exam. This simply means just because you see a herniated disc on an MRI, this does not necessarily mean the herniated disc is the cause of the back pain.

2. History and physical exam is the key to decide on the cause of the back pain. Therefore MRI should be interpreted in the context of history and physical exam.

3. A neurological exam by a neurologist not a neurosurgeon would be worthwhile when looking at severe back pain with possibility of surgery.

4. A radiologist who is fellowship trained in MRI would be most qualified to read your MRI exam. Always ask who will be reading your MRI.

5. MRI of hands and feet should be read by a fellowship trained radiologist in MRI as these are difficult to read and requires much experience.

6. X-ray examination should be done before MRI exam as X-rays may reveal enough information that MRI may no longer be necessary.

7. MRI exams are expensive therefore only specialists should be allowed to order these tests.

M. Rezaian, MD