Issa J. Dahabreh, MD, MS; Nira Hadar, MS; Mei Chung, PhD, MPH
Disclaimer: This article is based on a technical brief prepared by the Tufts Medical Center Evidence-based Practice Center under contract to the AHRQ (contract 290-2007-100551). The findings and conclusions in this article are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the AHRQ. Therefore, no statement in this report should be construed as an official position of the AHRQ or of the U.S. Department of Health and Human Services.
Acknowledgment: The authors thank Dr. Iovin Ramon and Ms. Srila Sen, who served as medical editors for the technical brief.
Financial Support: By contract 290-2007-100551 from the AHRQ.
Potential Conflicts of Interest: Drs. Dahabreh and Chung and Ms. Hadar: Grant (money to institution): AHRQ. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1239.
Requests for Single Reprints: Mei Chung, PhD, MPH, Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Box 63, Boston, MA 02111; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Dahabreh and Chung and Ms. Hadar: Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Box 63, Boston, MA 02111.
Author Contributions: Conception and design: I.J. Dahabreh, N. Hadar, M. Chung.
Analysis and interpretation of the data: I.J. Dahabreh, M. Chung.
Drafting of the article: I.J. Dahabreh.
Critical revision of the article for important intellectual content: N. Hadar, M. Chung.
Final approval of the article: I.J. Dahabreh, N. Hadar, M. Chung.
Provision of study materials or patients: I.J. Dahabreh.
Statistical expertise: I.J. Dahabreh.
Administrative, technical, or logistic support: M. Chung.
Collection and assembly of data: I.J. Dahabreh, N. Hadar, M. Chung.
Dahabreh IJ, Hadar N, Chung M. Emerging Magnetic Resonance Imaging Technologies for Musculoskeletal Imaging Under Loading Stress: Scope of the Literature. Ann Intern Med. 2011;155:616-624. doi: 10.7326/0003-4819-155-9-201111010-00009
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Published: Ann Intern Med. 2011;155(9):616-624.
Imaging under loading stress is hypothesized to improve the diagnostic value of magnetic resonancel imaging (MRI) for musculoskeletal conditions. This article reviews 57 studies about MRI under physiologic loading stress performed in an upright or sitting position or under axial loading by using a compression device. The most commonly imaged regions were the spine (33 studies) and knee (13 studies). Most studies had a cross-sectional (n = 37) or case–control (n = 13) design and reported on anatomical measurements rather than patient-relevant end points. Studies were generally small: The median (25th, 75th percentile) number of case patients was 26 (17, 45), and the median (25th, 75th percentile) number of control participants was 13 (12, 20 for case–control studies). Fifteen of 57 studies used at least 2 imaging tests and reported on diagnostic or patient-relevant outcomes but did not report meaningful information on the relative performance of the tests. In 10 studies that included information on adverse effects, 5% to 15% of participants reported new-onset or worsening pain and neuropathy during MRI under loading stress. Overall, evidence is insufficient to support the clinical utility of MRI under loading stress for musculoskeletal conditions.
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Neurology, Healthcare Delivery and Policy, Neuropathy, Prevention/Screening.
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