Overutilization of magnetic resonance imaging in the diagnosis and treatment of moderate to severe osteoarthritis

Advanced imaging is a major driver of health care expenditures. Magnetic resonance imaging provides advantages over radiography because of its ability to visualize soft tissues within the knee joint. The clinical relevance of these findings in osteoarthritis, however, is not well understood. For example, MRI can detect meniscal tears, but these are frequent findings in patients with osteoarthritis, with no difference in prevalence among those with and without symptoms. In addition to concerns about excessive cost, it is possible that patients may undergo unnecessary procedures due to MRI findings. A randomized placebo-controlled trial showed no benefit of arthroscopy for osteoarthritis. Our goal was to examine how prevalent this practice is at this institution, and to examine the characteristics of physicians who ordered these MRIs. Our hypothesis is that many providers order MRI for evaluation of osteoarthritis before referring to an orthopedic surgeon, and that providers with higher levels of training are less likely to order these unnecessary MRIs