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My MRI scan hit rate will include next radiologist who junks my referral

On the rare occasions I order an MRI scan, the least I expect is they bloody well get done.

On the rare occasions I order an MRI scan, the least I expect is they bloody well get done.



Last year the imaging department sent me a bundle of MRI scan request forms. I promised myself that I would only use them to order scans that might tell me something I couldn't find out some other way. As it turned out I've only ordered five, all on patients' knees.

So far I have a 75% hit rate – where the scan demonstrated a problem that wasn't discernible on the standard ‘look, feel and move' joint examination. Or during the far more entertaining, ‘look, feel, move, grind, distract, flex, twist, extend and shove' examination either.

This tells me that I'm probably ordering fewer scans than I should be – if I'm scoring points so often there must be other knees that I'm not scanning that have significant pathology.

Mathematicians amongst you will have noticed that it's not possible to achieve a 75% success rate on five pairs of knees.

I might have ordered five scans but only four have been performed.

Contestant number five (39yr year old restaurant worker, painful knee for years, XR showing nothing but ‘mild degenerative changes' but with obvious calf muscle wasting ) was unlucky enough to get nothing more than a consolation prize ultrasound scan that ruled out a Baker's cyst and a bounce back to me to organise another (pointless) X-Ray and an orthopaedic referral.

I'm willing to accept that an MRI might not be the investigation of choice. What hacks me off is that the radiologist took it upon himself to junk my request and perform a test that tells me and the patient jack all that we don't already know.

I'm in the phone book, all he had to do was call me and talk things over.

I mean, what's the point of issuing guidelines and allowing GPs access to investigations if our requests are going to be ignored?

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