Appropriate use of magnetic resonance imaging of the spine and extremities

The incidence of inappropriate use of magnetic resonance imaging (MRI) by nonsurgeon physicians for evaluation of musculoskeletal disorders is high when assessed using treatment-oriented criteria in a university medical center. The charts of 71 patients who underwent 90 MRIs of the spine or extremity revealed an inappropriateness rate of 22%. The rate of inappropriateness was higher in the outpatient setting and varied little according to the anatomic region studied. The indications for surgical treatment and the benefits of diagnostic studies such as MRI for disorders of the musculoskeletal system must be thoroughly understood to justify the expense.