MRIs, x-rays, and other imaging technologies allow us to see the bones, muscles, and other tissues that make up your knee. Scans and images can help doctors and researchers identify serious problems in the body that need attention.

But do the results of those images tell you why you have pain?

Imaging has a very important place in medicine. But research shows that there isn't always a direct link between imaging results and your symptoms.

In other words, the results of your scans are often not the reason for your pain. Let’s take a look at some of the latest statistics:

  • Studies show that less than 50% of people with osteoarthritis on x-rays have knee pain. [1]

  • Out of 98 “pain-free” athletes under 26 years old, only 4% had MRI results that were considered “normal” by musculoskeletal radiologists. [2]

  • In the New England Journal of Medicine, one study found that over 60% of MRIs with meniscal tears observed belonged to people who did not have any knee pain, aching, or stiffness. [3]

  • A new study found that more than 40% of MRIs were “arguably useless.” These researchers now recommend that doctors think twice before performing an MRI. [4]

We know that everyone’s experience of pain is different because everyone carries different factors in their backpack.* We also know that people’s knees are unique. It’s common to have differences in your left and right knee, just as your dominant arm is probably stronger than your non-dominant arm.

Even so, you may still be wondering why you have pain if it’s not directly related to what imaging shows.

In previous articles we’ve talked about why persistent pain is complex and why there is no single solution for treating long-term pain. It takes time to address the various factors in your backpack, calm your nervous system, and retrain your body.*

Remember that there is always something you can do to improve your knee health and knee pain. Movement and knowledge will get you there. With patience, consistency, and courage, you will slowly get better.

In future lessons, we’ll teach you how to focus on the great things your knee allows you to do and feel safe as you move more, despite “abnormalities” on your scans.

* We added a video and additional content to the article “Rethink Your Pain,” which you read in a previous playlist. In case you missed it, be sure to take a look at “Rethink Your Pain” in the Library of your Hinge Health app for important background information and context.

Key Takeaways

  1. Results from imaging technologies like MRIs & x-rays don't always reflect symptoms.

  2. It is common for people without any pain or symptoms to have abnormal findings on their scans.

  3. Don't rely on scans alone. There is always something you can do to take control of your knee health.

References: 

  1. Bedson, J., & Croft, P. R. (2008). The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskeletal Disorders9, 116.

  2. Rajeswaran, G., Turner, M., Gissane, C., & Healy, J. C. (2014). MRI findings in the lumbar spines of asymptomatic elite junior tennis players. Skeletal Radiology43(7), 925–932.

  3. Englund, M., Guermazi, A., Gale, D., Hunter, D. J., Aliabadi, P., Clancy, M., & Felson, D. T. (2008). Incidental Meniscal Findings on Knee MRI in Middle-Aged and Elderly Persons. New England Journal of Medicine359(11), 1108–1115.

  4. Song, Y. D., Jain, N. P., Kim, S. J., Kwon, S. K., Chang, M. J., Chang, C. B., & Kim, T. K. (2015). Is Knee Magnetic Resonance Imaging Overutilized in Current Practice? Knee Surgery & Related Research27(2), 95–100.

  5. Halilaj, E., Le, Y., Hicks, J. L., Hastie, T. J., & Delp, S. L. (2018). Modeling and predicting osteoarthritis progression: data from the osteoarthritis initiative. Osteoarthritis and Cartilage26(12), 1643–1650.

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