What your MRI report actually says

An MRI report is a description of what the radiologist sees.

It is not a verdict on what is causing your pain.

And because MRI is very good at detecting small abnormalities, the report can sometimes sound much more alarming than the clinical problem actually is.

“Degenerative changes”

Usually means changes associated with wear over time.

They are common as we get older and do not necessarily explain pain.

“Increased signal” or “signal change”

This means the tissue looks different from its usual appearance on MRI.

The significance depends on the structure, location and pattern.

It does not automatically mean a major tear.

“Effusion”

This means there is excess fluid in the joint.

It tells us that the joint is reacting to something.

It does not, by itself, tell us what that something is.

“Chondral thinning”

This means the cartilage covering the joint surface is thinner than expected.

It can be an important finding, but its significance depends on where it is, how extensive it is and whether it fits your symptoms and examination.

“Bursitis” or “tendinosis”

These describe changes in soft tissues around the joint.

They may be responsible for symptoms—or they may simply coexist with the actual problem.

The part that matters

A scan finding matters when it fits the patient.

Your symptoms tell us what you are experiencing.

The examination tells us what structures are likely responsible.

The imaging helps confirm, refine and sometimes change that understanding.

That is why we prefer to look at the images with you rather than simply hand you a report and a recommendation.

Have an MRI you don’t understand?

Bring the report and the images.

We can go through what is actually relevant, what may simply be an incidental finding, and what—if anything—needs to happen next.

One principle across all of these conditions

A scan can tell us what is there.

It cannot always tell us what you should do.

That decision comes from putting the imaging together with your symptoms, examination, goals, activity level and the realistic alternatives.

Sometimes the answer is surgery.

Sometimes it is rehabilitation.

Sometimes it is waiting.

Sometimes it is preserving the joint rather than replacing it.

And sometimes the most useful thing a surgeon can tell you is:

“You don’t need an operation.”

That is not a failure to treat you.

That is the treatment decision.