[www.keralites.net] The latest in MRI technology? Report says a physical examination better

 

Knee Pain – let the doctor do a physical examination and ditch the MRI The more things change the more things stay the same. For decades doctors doubted the effectiveness of MRI in making a true determination in the treatment of chronic knee pain. But when you cite studies from the 1980s, 1990s or even the 2000s, people often say that was a different time and that technological advancements have exploded. But as in 1993, and we guarantee in 2013, you will not be able to convince a patient to put away their MRIs and admit that they have no place in healing based on the current technology. Lets look at a study published just one month ago on November 19, 2012 titled Relationships between Pain, Function and Radiographic Findings in Osteoarthritis of the Knee: A Cross-Sectional Study. Let's assume that in the last month there has not been a quantum leap in MRI technology. Knee Osteoarthritis: MRI vs. Physical Examination The aim of this study was to investigate the relationships between pain, disability, and radiographic findings in patients with knee osteoarthritis. A total of 114 patients with knee osteoarthritis who attended the physical medicine and rehabilitation outpatient clinic were included in this study. The mean age of the patients was 57 years old and the average disease duration was about 4 years. The diagnosis was based on the American College of Rheumatology (ACR) criteria for knee osteoarthritis. Researchers recorded the age, duration of disease, and body mass index (BMI) of all patients. They examined patients using both radiographic technology and patient-reported pain and function. Radiographic features on the two-sided knee radiography were assessed with the Kellgren-Lawrence scale (a standard method of determination). The severity of knee pain, stiffness, and disability were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC – another standard assessment determination scale). What did they find? Kellgren-Lawrence grading scale and age or disease duration were positively and significantly associated, whereas none of the WOMAC subscores were found to be related with Kellgren-Lawrence grading scale. In other words, the physical examination and the MRI did not agree! Alternatively, WOMAC disability scores were significantly associated with WOMAC pain and WOMAC stiffness. In other words, the physical examination found the source of pain without film! Here is the important conclusion: "Knee pain, stiffness, and duration of disease may affect the level of disability in the patients with knee osteoarthritis. Therefore treatment of knee osteoarthritis could be planned according to the clinical features and functional status instead of radiological findings." What a nice way to say that radiological findings should be ditched.1 Prolotherapists tend to use a physical examination to discover the root cause of pain, no expensive technology needed and misdiagnoses can be avoided. Contact us for more on Prolotherapy and its role in knee osteoarthritis. 1. Cubukcu D, Sarsan A, Alkan H. Relationships between Pain, Function and Radiographic Findings in Osteoarthritis of the Knee: A Cross-Sectional Study. Arthritis. 2012;2012:984060. doi: 10.1155/2012/984060. Epub 2012 Nov 19.

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