Related Experiment Video
Updated: Oct 13, 2025
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Incidence Rates of Surgery After Knee MRI: Association According to Referring Physician Type and Patient's Age and
Syed R Naqvi1, R Cole Beavis2, Prosanta Mondal3
1Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Background:
The utility of magnetic resonance imaging (MRI) in the primary care setting is uncertain, with a perception that there is less likelihood for surgery after MRI ordered by general practitioners (GPs) when compared with orthopaedic surgeons and sports medicine physicians. Additionally, the influence of patient age and sex on subsequent surgical intervention is currently unknown.
Purpose/Hypothesis:
The purpose of this study was to compare surgical incidence after MRI referrals by orthopaedic surgeons, GPs, and sports medicine physicians, including a subset analysis for GP patients based on type of approval given by the radiologist. The authors also wanted to explore the association of age and sex on subsequent surgical intervention. They hypothesized that surgical incidence after MRI ordered by orthopaedic surgeons and sports medicine physicians would be higher than after MRI ordered by GPs.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Knee MRI referrals by the 3 physician cohorts during May to December 2017 were assessed. For GP patients, the types of approval or recommendation from a radiologist were categorized. Subsequent surgical intervention status was then compared among referral groups up to 2 years after MRI. Associations of age and sex with surgical occurrence were also assessed. Chi-square test, analysis of variance, and univariate/multivariable logistic regression were used for statistical analysis.
Results:
Overall, 407 referrals were evaluated (GP, n = 173; orthopaedic, n = 176; sports medicine, n = 58). Surgical incidence was not significantly higher for orthopaedic and sports medicine than GP referrals at 3 months (10%, 3%, and 6%, respectively; P = .23), 6 months (20%, 17%, and 15%; P = .49), and 2 years (30%, 35%, and 24%; P = .25). Surgical incidence for GP patients was higher after discussion with a radiologist or when evaluating specific pathology on prior imaging versus less defined reasons (30.4% vs 15.7%, respectively; P = .03). Surgical incidence was lower for older patients (11% vs 31% for >60 years vs all other age groups combined; P = .002), and women were less likely to undergo surgery than men (22% vs 35%, respectively; P = .008).
Conclusion:
Surgical incidence after MRI was likely appropriately lower for older patients. Lower incidence for female patients is of uncertain cause and warrants further study.
Insights
Magnetic resonance imaging (MRI) referrals by general practitioners (GPs) did not lead to significantly lower surgical incidence compared to specialists. Older patients and women were less likely to undergo surgery following MRI.
Area of Science:
- Orthopaedic Surgery
- Radiology
- Primary Care Medicine
Background:
- The role of magnetic resonance imaging (MRI) in primary care is debated, with concerns about lower surgical rates after general practitioner (GP) referrals versus specialist referrals.
- The impact of patient age and sex on surgical intervention following MRI is not well understood.
Purpose of the Study:
- To compare surgical rates after knee MRI referrals by orthopaedic surgeons, GPs, and sports medicine physicians.
- To analyze GP referrals based on radiologist recommendations.
- To investigate the association of patient age and sex with subsequent surgical intervention.
Main Methods:
- A cohort study evaluated 407 knee MRI referrals from May to December 2017.
- Surgical intervention status was compared among referral groups up to two years post-MRI.
- Statistical analyses included chi-square tests, ANOVA, and logistic regression to assess referral source, radiologist recommendations, age, and sex.
Main Results:
- No significant difference in surgical incidence was observed between GP, orthopaedic, and sports medicine referrals at 3 months, 6 months, or 2 years.
- GP patients with radiologist-approved specific pathology or prior imaging review had higher surgical incidence (30.4%) than those with less defined reasons (15.7%).
- Older patients (>60 years) and women showed significantly lower rates of surgical intervention.
Conclusions:
- MRI referrals from GPs are associated with appropriate surgical rates comparable to specialists.
- Surgical incidence is appropriately lower in older patients post-MRI.
- The lower surgical incidence in women warrants further investigation.
More Related Videos
![Quantitative [18F]-Naf-PET-MRI Analysis for the Evaluation of Dynamic Bone Turnover in a Patient with Facetogenic Low Back Pain](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F58491.jpg&w=3840&q=50)
06:31Quantitative [18F]-Naf-PET-MRI Analysis for the Evaluation of Dynamic Bone Turnover in a Patient with Facetogenic Low Back Pain
Published on: August 8, 2019
07:22Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes
Published on: March 7, 2025
Related Concept Videos
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:27Imaging Studies IV: Magnetic Resonance Imaging
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:24Magnetic Resonance Imaging