Improving Effective Magnetic Resonance Imaging (MRI) Application in Soft Tissue Wrist Injury.

Area of Science:

• Orthopedic Surgery
• Radiology
• Health Services Research

Background:

• Magnetic resonance imaging (MRI) for soft-tissue wrist injuries may be overutilized.
• Ineffective use of healthcare resources is a concern.
• Identifying predictive factors for MRI utility is crucial.

Purpose of the Study:

• To identify clinical factors that predict whether MRI influences treatment recommendations for soft-tissue wrist injuries.
• To improve the appropriate application of MRI in diagnosing wrist injuries.

Main Methods:

• Retrospective chart review of adult patients undergoing wrist MRI for soft-tissue injury (June 2009-June 2014).
• Analysis of clinical data and treatment recommendations before and after MRI.
• Defining 'Impact MRI' as a change in treatment recommendation post-imaging.

Main Results:

• Of 140 MRIs, 39 (28%) impacted treatment.
• Impact MRIs were more likely when ordered by hand surgeons (P = .001).
• Independent predictors for Impact MRI included younger age (<36 years), symptom onset within 6 weeks, specific anatomical diagnosis, and ordering by a hand surgeon.

Conclusions:

• MRI for soft-tissue wrist injuries is more likely to alter management in younger patients, within 6 weeks of symptom onset, and with a specific diagnosis.
• Referral to a hand surgeon is recommended before MRI for older patients, those with chronic symptoms, or unclear diagnoses.