Lumbar Spine MRIs Are Widely Ordered and Frequently Misinterpreted
Low back pain is one of the most common reasons people seek medical care. It's also one of the top reasons doctors order imaging, especially MRIs. That’s why the lumbar spine MRI has become one of the most frequently performed imaging exams in modern healthcare. However, despite how commonly it's used, lumbar spine MRIs are also known to be among the most frequently misdiagnosed imaging studies, often due to interpretation errors by radiologists.
How Common Are Lumbar Spine MRIs?
- An estimated 15 million lumbar spine MRIs are ordered annually in the United States.
- Spine-related complaints account for over 25% of outpatient imaging referrals.
- Back pain is the third most common reason for visits to the doctor.
These numbers demonstrate the demand for accurate imaging in diagnosing spine conditions. However, the unfortunate truth is that research shows many lumbar spine MRIs are either misinterpreted or not fully understood by referring physicians.
High Rate of Misdiagnosis in Lumbar Spine MRIs
A 2017 study published in The Spine Journal found that:
- Over 40% of lumbar spine MRI reports contained significant discrepancies when reviewed by a spine subspecialist.
- Nearly 50% of patients who received a second opinion had a change in diagnosis or treatment plan.
Interpretation accuracy depends heavily on the radiologist's training. General radiologists who may be interpreting a wide variety of exams in a given day may lack the specialized expertise required for subtle findings in spinal anatomy. This can lead to missed diagnoses or overcalling abnormalities that are not clinically relevant.
Commonly Misdiagnosed Findings on Lumbar Spine MRI
These are some of the most frequently misdiagnosed or mischaracterized findings:
1. Disc Herniation
Often misidentified or overcalled when a disc bulge is mistaken for a herniation.
2. Disc Bulge vs. Herniation
Terminology confusion can result in unnecessary treatments or surgical referrals.
3. Annular Fissures (Tears)
These are subtle but can be critical in diagnosing discogenic pain. They’re often missed or not labeled.
4. Nerve Root Compression
Can be overlooked in mild cases or when imaging quality is poor.
5. Modic Changes
Indicate vertebral endplate inflammation; often ignored, though relevant in chronic pain cases.
6. Spinal Stenosis
Severity is frequently underestimated or overestimated, which can influence surgical decision-making.
7. Facet Joint Arthritis (Arthropathy)
Findings are sometimes overstated or not correlated properly with symptoms.
8. Spondylolisthesis
May not be seen clearly on a supine MRI, and dynamic instability may be missed.
9. Bone Marrow Lesions or Tumors
Subtle marrow changes can be missed or dismissed without contrast imaging.
10. Post-Surgical Findings
Distinguishing scar tissue from recurrent disc herniation can be difficult without contrast and experience.
Why Subspecialist Review Matters
Musculoskeletal (MSK) and neuroradiologists are fellowship-trained to focus specifically on the spine and surrounding structures. Their detailed understanding allows for more accurate and clinically useful interpretations.
A second opinion from a subspecialist can:
- Confirm or correct the initial diagnosis
- Help avoid unnecessary or inappropriate surgery
- Guide a more precise treatment plan
- Provide greater clarity for patients and their care team
When Should You Get a Second Opinion?
Consider seeking a second opinion on your lumbar spine MRI if:
- Your MRI report does not match your symptoms
- You are considering surgery or injections
- You’ve had spine surgery and still experience symptoms
-
You were told your MRI was “normal,” but pain persists
Get your MDView Lumbar MRI Second Opinion Today
Lumbar spine MRIs are one of the most commonly ordered imaging tests, but also one of the most misdiagnosed, especially when not reviewed by a spine imaging specialist. If you're facing an important decision about your back pain treatment, or your symptoms don't match what your doctor is telling you, a second opinion from a subspecialty radiologist can give you the clarity and confidence you need to move forward.
At MDView, we connect patients with board-certified radiologists who specialize in spine and musculoskeletal imaging. Your expert second opinion is delivered within 72 hours or less.
Get clarity today! Upload your exam to https://app.mdview.com to connect with a specialist and learn more about your lumbar MRI report.
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