Despite the natural history of low back pain being generally favorable, several invasive treatment modalities, including surgery, are increasingly being offered. Furthermore, there is an increase in MRI use, which can have a negative impact on patients due to its nocebo effect, resulting from the negative interpretation of incidental changes such as degeneration, tears, ruptures, and neural compression. These interpretations can result in patients and clinicians/surgeons feeling that an intervention is required for the spine to return to normal.
 
The negative impact that MRI reports can have on patients and the health care professionals providing primary care for LBP had not been formally assessed (yet, we have all seen this in practice!).
 
The purpose of this study was three-fold: 1) the authors performed a randomized control trial to study the effect of routine MRI reports on the perception of the patient and treatment functional outcomes; 2) they devised a clinical method of MRI reporting to avoid fear and catastrophization in patients; and 3) the authors conducted a blinded study to assess the effect of reporting on the perception of the spine condition and subsequent decision making by various health care providers.
 
On a personal note, I have always thought there should be two versions of a radiology report – one written for medical professionals, containing all the ‘lingo’, and a patient-facing version containing simple language and even some degree of reassurance in warranted cases. I know this is not likely to happen, but it could prevent much of the angst and miscommunication that occurs because of imaging for LBP patients. This study further reminds us how powerful our words, and those contained in imaging reports, can be and how they can directly influence patient outcomes in both the short and long terms.
 
THIS WEEK'S RESEARCH REVIEW: “Catastrophization Effects of MRI Report & Benefits of ‘Clinical Reporting’”
 
This paper is in press (at time of posting) in the European Spine Journal (2021) and this Review is posted in Recent Reviews, Diagnostic Imaging, Clinical Practice, Low Back Pain and the 2021 Archive.
 
 
Catastrophizing

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