Health Organization for Pudendal Education

Recently, I had an MRI of the abdomen and pelvis. I received a copy of the actual MRI and looked at it. I noticed right away there was a signal change in the obturator internus muscle on the right side which would indicate that that the muscle has atrophied. This finding I knew was new compared to my last MRI 4 years ago. When I received the MRI report it was an abysmal read, to say the least. There were abnormalities I had on my most recent CT that were not reported, there were findings on my last MRI that weren't reported, plus I've known for 12 years I've had a benign adrenal mass that was not reported. I was not a happy camper to say the least. I first called the ordering physicians office and spoke with the NP. She got back to me and told me the doctor said if I had problems with the MRI report I needed to take it up with Radiology. I called the Radiology Department and spoke with a very helpful representative who deals with patients concerns and complaints. Yesterday I spoke with the attending who read my MRI. Originally, a fellow read my MRI and when he reviewed my MRI with the fellow he pointed out some observations that were missed such as the obturater internus muscle plus my other findings from previous MRIs that were missed. He did not check before the report was sent out that the fellow made the changes they had discussed. I had a good conversation with the radiologist about quality control of MRI readings and that not everything a radiologist sees on an MRI is reported because sometimes they think it might be artifact. We discussed the differences in the MRI machines and how that can contribute to what can and cannot be seen on an MRI.

The take home message. If you have a normal MRI it might not be an accurate read. You might want to consider having the physician who ordered the MRI look at it with you to double check as they know your medical history where the radiologist doesn't. Second, if you can choose where to have your MRI done, pick the facility with the best MRI machines. I could have croaked when I asked the tech if it was a 1.5T or a 3.0T and she told 1.5T and gave me all kinds of rationales why the 1.5T was just fine. I knew better but didn't fight with her. Sometimes just better to keep my mouth shut. However, I will never make that mistake again.

My MRI report is being corrected. We must always advocate for ourselves and make sure your reports are accurate.

Thank you for sharing this, nyt.

NYT how were you able to detect a signal change in your obturator internus muscle? Are you able to read an MRI? Or were you comparing reports?

I learned very basic MRI and CT scan skills when I was in graduate school. All you do is look at your images and compare the same muscle or bone on each side to each other and make sure the signal intensity is the same, if they are not, there is a pathology. For example, if you look at the piriformis muscle you look at the right side and then the left side to make sure the color intensity is the same on both sides. You can find great MRI images on Google that the pelvic structures are labeled and you can figure out what muscle you are looking at. I can't diagnose based on what I was taught and certainly can't explain all the different type of parameters they use and what they mean to diagnose. I know just enough to cause trouble . When I have time I'll try and post a picture from my MRI for you to see.

Hi NYT,
Thanks so much for sharing your experience. This is a rather touchy subject with me. I've had a lot of inconsistencies and discrepancies with my imaging over the past few years.
For example, I had a pelvic MRI this past October which reported "Unremarkable pelvis". Apparently, the person who interpreted my images didn't think it was noteworthy that:

I recently had surgery for TCD - sacral lamina had to be reconstructed. My surgeon must have done a fabulous job!
Bilateral ankylosis of the SIJ's with measurable synovial cysts protruding into the iliacus muscle - this has been a consistent finding for the past several years.
No mention of surgical changes from bilateral PN surgery. Not even that I don't have SSL's anymore.
No mention of the surgical changes from the ilioinguinal/iliohypogastric neurectomies.
Not even a mention of surgical changes from a TOTAL hysterectomy.

I had the TC's for more than 4 years, before they were even noted on my MRI's as "stable, incidental findings".

This statement fascinates me:

nyt wrote:You might want to consider having the physician who ordered the MRI look at it with you to double check as they know your medical history where the radiologist doesn't.

Personally, I haven't had much success with that. Most ordering physicians aren't able to read the images. I've had the same experience as you, where I would contact the ordering doctor, who refers me to radiology. Even more frustrating, my images have been brought back to the SAME interpreter to be re-read, instead of honoring my request to have someone else take a look at them.

nyt wrote: I could have croaked when I asked the tech if it was a 1.5T or a 3.0T and she told 1.5T and gave me all kinds of rationales why the 1.5T was just fine.

Yup; can relate to that one, too. However, while I agree with you about having your scans done by the best possible machines; I think it's more important to find a skilled radiologist who is adept with identifying abnormalities. Still struggling with this.

Kindest of regards,
Karyn

Karyn,

I am so sorry to hear that you were unable to get your misreads and misinformation resolved. It is certainly a difficult situation that it puts the patients in. Frustrating to say the least.

And you are right, many physicians can't read the MRI they ordered for you to confirm what the radiologist saw or if they see something amiss. Fortunately, in the past my youngest son had misreads by the radiologist but the ordering physicians caught the error which saved him two unnecessary surgeries.

I wish I had some answers to help fix this problem in order for all patients to have better care.