Put x-rays ahead of MRI, say surgeons

GPs should have to provide evidence of prior x-ray before ordering MRI for musculoskeletal conditions in children, orthopaedic surgeons say in a letter to the MJA.

The surgeons describe two cases where treatment was delayed because MRI, as an initial investigation, failed to make the diagnosis. A large tibial spur and a slipped capital femoral epiphysis (SCFE) were later diagnosed on x-ray, which remains the “gold standard for diagnosing most musculoskeletal conditions in children”, the letter says.

Delays in diagnosing SCFE can have a “devastating outcome”, says co-author Dr