MRI for Traumatic Knee Injury Does Not Add to Improvement in Outcome

Magnetic resonance imaging for traumatic knee injuries, referred by general practitioners, leads to higher healthcare costs without improvement in outcomes, according to a study published in the journal Radiology.

Researchers from the Netherlands performed a cost-utility analysis parallel to a prospective randomized controlled trial of 356 patients who presented with traumatic knee symptoms. The group, mean age 33 years (from 18 to 45), included 222 men.

A total of 177 patients were randomly assigned to usual care, which did not include MR imaging, but patients were referred to an orthopedic surgeon when conservative treatment was unsatisfactory. The remaining 179 patients were referred for MR imaging within two weeks after injury. Main outcome measures were quality-adjusted life years (QALYs) and costs from a healthcare and societal perspective.

The results showed mean QALYs were 0.888 in the MR imaging group and 0.899 in the usual care group. Healthcare costs per patient were higher in the MR imaging group (€1,109) than in the usual care group (€837), mainly due to higher costs for MR imaging, with no reduction in the number of referrals to an orthopedic surgeon in the MR imaging group.

The researchers concluded that referral for MR imaging referral by general practitioners was not cost-effective in patients with traumatic knee symptoms and that MR imaging led to more healthcare costs, without an improvement in health outcomes.