75^th Annual Meeting Poster Presentations

Over-Utilization of MRI in the Osteoarthritis Patient

Poster Presentation Number: P145

Location: Moscone Convention Center

Adult Reconstruction Knee

Alexander C Gordon, MD Highland Park IL
Jill Branson, RN Kildeer IL
Christopher Simmons Willow Springs IL
Kimberly A Berland, CST Warrenville IL
Daniel S Willsey, MS, PA-C Dayton OH
Amanda L Andrews, PA-C Des Plaines IL
Wayne M Goldstein, MD Morton Grove IL

We studied a random sample of 50 patients with primary total knee arthroplasty for osteoarthritis to see if within the last two years they had an unnecessary MRI of their knee.

Medical imaging now consumes 10% to 15% of Medicare payments to physicians, compared with less than 5% only a decade ago. Imaging costs are expected to keep growing at an annual rate of 20% or higher, now outpacing the cost of prescription drugs. Over-utilization of MRI contributes to cost, especially in a radiographically proven osteoarthritic knee.

A random sample of 50 patients with primary total knee arthroplasty for osteoarthritis were reviewed to see if within the last two years they had an MRI of their knee. Data was obtained by chart review and phone call to verify that the patient had MRI prior to seeing the senior author for total knee arthroplasty. The senior author routinely obtains routine knee radiographs including weight-bearing views. These patients had TKA due to evidence of bone on bone articulation in any or all of the three compartments.

32 of 50 patients had MRI done prior to consultation, which was ordered by their primary care or orthopaedic physician. More than half did not have radiographs prior to being seen.

There is no or minimal benefit to MRI in patients with osteoarthritis of the knee. The patient is often referred by Primary Care with the finding of 'torn meniscus' and many patients expect arthroscopy and seem upset that the orthopedic surgeon does not use the MRIs. The average reimbursement by Medicare for MRI of the knee is $582.27. Commercial insurance can be significantly higher. Possibly due to lack of musculoskeletal education, MRI is ordered instead of x-rays. This study suggests the need for strict guidelines or credentialing of those who order musculoskeletal MRIs.

A ^· to the left of the title indicates the FDA has not cleared the drug or device for the described purpose.

Wednesday - Friday	7:00 AM - 6:00 PM
Saturday	7:00 AM - 5:30 PM
Sunday	7:00 AM - 12:30 PM

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