A recent article published in The NY Times suggested that 1) MRI’s are overused in sports medicine practice 2) in asymptomatic athletes an MRI will always find an abnormality. One sports medicine orthopaedist analyzed the results of 31 MRI shoulder scans of professional baseball pitchers, to find that 90% of them had abnormal shoulder cartilage and 87% of them had abnormal rotator cuff tendons. However, all athletes were perfectly healthy!

A study by Alyas et al. (2007) published data on MRI lumbar spine scans of elite adolescent tennis players. The aim of the study was to report baseline MRI findings of the lumbar spine in asymptomatic players. 33 players (average age 17) were underwent MRI scans where the following results were demonstrated: 28 players (84%) had abnormal examinations including pars lesions of L4 and L5, some players showed early signs of facet arthropathy at L5/S1, some athletes showed mild degeneration, and others showed hypertrophy of the facet joint. Synovial cysts were identified, and as were bulging discs at L4-L5, and L5-S1.

Implications

While elite sports environments have become increasingly medicalised in recent times, caution needs to be exercised in how diagnostic images are interpreted.