Magnetic resonance imaging in evaluating workers' compensation patients.

Area of Science:

• Orthopedic Surgery
• Radiology
• Healthcare Economics

Background:

• Workers' compensation cases involving hand conditions often undergo advanced imaging.
• The diagnostic utility and cost-effectiveness of these imaging studies are frequently questioned.

Purpose of the Study:

• To evaluate the clinical utility of magnetic resonance imaging (MRI) for workers' compensation patients with hand conditions.
• To compare MRI findings with subsequent clinical diagnoses and assess the impact on patient management.
• To investigate the approximate cost of these MRI studies.

Main Methods:

• Retrospective chart review of 62 workers' compensation patients over 3 years.
• Analysis of referral diagnoses, radiologist's MRI diagnoses, and senior author's clinical diagnoses.
• Assessment of whether MRI was necessary for diagnosis and treatment planning.

Main Results:

• MRI studies did not contribute to the clinical diagnosis in any of the 62 reviewed cases.
• Clinical diagnosis disagreed with MRI diagnosis in 63% of patients.
• MRIs were unnecessary and did not influence treatment; 67 scans cost approximately $53,000.

Conclusions:

• Pre-referral MRI studies for workers' compensation hand conditions are frequently unnecessary and do not improve diagnostic accuracy.
• The use of costly imaging like MRI may not be the standard for accurate diagnosis and can potentially misdirect patient care.
• Resource allocation in workers' compensation healthcare warrants careful consideration of imaging study necessity.