{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T23:58:48Z","timestamp":1762041528726,"version":"build-2065373602"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"name":"United States Department of Veterans Affairs Biomedical Laboratory R&D (BLRD) Service","award":["IK2 BX004879"],"award-info":[{"award-number":["IK2 BX004879"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>MRI is an essential diagnostic imaging modality for many knee conditions; however, it is not indicated in the setting of advanced knee arthritis. Inappropriate MRI imaging adds to health care costs and may delay definitive management for many patients. The primary purpose of this study was to ascertain the frequency of inappropriate MRI scans performed at one Veterans' Administration Medical Center (VAMC). We performed a retrospective chart review of all knee MRIs ordered over a 6-month period. Inappropriate MRI was defined as MRI performed prior to radiographs (XRs), or in the presence of XRs demonstrating severe osteoarthritis, without leading to a nonarthroplasty procedure of the knee. Of the 304 cases reviewed, 36.8% (112) of the MRIs were deemed inappropriate, 33 were ordered by orthopedists, and 79 were ordered by other health care providers. Of the 33 ordered by orthopedists, 25 were ordered by retired\/nonsurgical orthopedists. Obtaining an MRI delayed care by an average of 29.2 days. Of the 252 cases that had XR prior to MRI, none included all four views in the standard knee XR series and only four had weightbearing images. Over a third of knee MRIs performed at this VAMC were inappropriate and delayed care. Additionally, no XRs in our study contained all the necessary views to properly assess knee arthritis. These concerning findings signify a potential opportunity for education in diagnostic strategies, to better patient care and resource utilization in the VAMC.<\/jats:p>","DOI":"10.1055\/s-0041-1733880","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T22:52:03Z","timestamp":1630623123000},"page":"305-309","source":"Crossref","is-referenced-by-count":4,"title":["Is MRI Overutilized for Evaluation of Knee Pain in Veterans?"],"prefix":"10.1055","volume":"36","author":[{"given":"Scott","family":"Koenig","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Orthopaedics, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9642-9850","authenticated-orcid":false,"given":"George","family":"Morcos","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Orthopaedics, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan","family":"Gopinath","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Orthopaedics, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Veterans Affairs Commission, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5794-4294","authenticated-orcid":false,"suffix":"3rd","given":"Frank","family":"Henn","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Orthopaedics, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie L.","family":"Leong","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Orthopaedics, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"issue":"17","key":"ref1","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.2106\/JBJS.N.01141","article-title":"Prevalence of total hip and knee replacement in the United States","volume":"97","author":"H Maradit Kremers","year":"2015","journal-title":"J Bone Joint Surg Am"},{"issue":"02","key":"ref2","first-page":"348","article-title":"Arthritis prevalence and symptoms among US non-veterans, veterans, and veterans receiving Department of Veterans Affairs Healthcare","volume":"33","author":"K L Dominick","year":"2006","journal-title":"J Rheumatol"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1002\/acr.22412","article-title":"Lifetime medical costs of knee osteoarthritis management in the United States: impact of extending indications for total knee arthroplasty","volume":"67","author":"E Losina","year":"2015","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/j.apmr.2013.10.032","article-title":"Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain","volume":"95","author":"V Y Ma","year":"2014","journal-title":"Arch Phys Med Rehabil"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2106\/JBJS.L.00206","article-title":"Estimating the burden of total knee replacement in the United States","volume":"95","author":"A M Weinstein","year":"2013","journal-title":"J Bone Joint Surg Am"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1136\/ard.16.4.494","article-title":"Radiological assessment of osteo-arthrosis","volume":"16","author":"J H Kellgren","year":"1957","journal-title":"Ann Rheum Dis"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1002\/art.1780290816","article-title":"Development of criteria for the classification and reporting of osteoarthritis. 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