When the pieces don’t seem to fit
Can an MRI Miss the Cause of Pain?
Can an MRI miss what is causing your pain? Learn what MRI can show, what it cannot establish alone and when further assessment may be useful.
Yes. An MRI can be normal or inconclusive even when pain is real, without the scan necessarily having been performed or reported incorrectly.
MRI is excellent at showing many anatomical structures. It is not a direct picture of pain and cannot answer every clinical question.
The relevant problem may lie outside the scanned area, require a different protocol or investigation, appear mainly during activity or depend more heavily on the history and examination.
What is MRI good at?
Depending on the region and protocol, MRI can show discs, nerves, ligaments, tendons, muscles, cartilage, bone marrow and joint fluid. It is valuable when requested for the right reason.
Why might it not provide the answer?
A scan examines a selected area, uses a selected protocol and is usually performed while you lie still. Some conditions are primarily clinical diagnoses and pain can persist without ongoing visible damage.
Could something have been missed?
No test is infallible, but a non-explanatory result is not proof of error. First clarify the region examined, clinical information supplied, scan quality, intended question and whether symptoms have changed.
Should the MRI be repeated?
Further imaging is more reasonable when symptoms have materially changed, objective signs have appeared, the suspected area was not covered or the result would guide a specific procedure or referral.
The bottom line
The answer is not always another scan. It is a clearer clinical question and a review of the whole picture.
When should you seek urgent help?
Seek urgent medical assessment for rapidly worsening or potentially serious symptoms, significant trauma, new progressive weakness, new bladder or bowel disturbance, saddle-area numbness, a hot swollen joint with fever, or if you are acutely unwell.
Project Sherlock is not an emergency or urgent-care service. If you think you may have an urgent medical problem, contact NHS 111, an appropriate urgent-care service or 999 in an emergency.