When the pieces don’t seem to fit
How to Read Your MRI Report
Been handed an MRI report and not sure what it means? Learn what the report describes, what it cannot settle and which questions to take to it.
An MRI report is written for the clinician who requested the scan, not for the person who had it. Learning the shape of one is useful, because it stops the report becoming a source of worry nobody has explained to you.
But the report describes what was seen on the images. It is not a diagnosis, and it does not tell you what is causing your symptoms. Often the most useful thing in it is the question it was asked to answer.
Very few people are told how to read their own scan report, and it is one of the more unsettling documents most of us ever receive. It is full of unfamiliar words, it is not written for you, and it arrives without anybody explaining what it means.
Here is the structure of one, what the common phrases describe, and what to do with it.
What is an MRI report?
An MRI report is a description of what was seen on the images, written by a radiologist. It normally has a heading with the examination and why it was done.
Then the clinical information sent with the request. Then the findings describing the images. Then the impression, which is the radiologist's own summary.
The most important thing about that structure is that the scan was requested with a question in mind. The request tells the radiologist what to look for.
That means the report is an answer to that question, which may or may not be the question you are actually asking.
How is it put together?
You do not need to learn the language to get value from a report. Three things are worth finding: the clinical information, which tells you what question was asked; the findings, which describe the images; and the impression, which is the summary.
Reports also often mention things that were seen but are not the reason for the scan. That is normal.
Images show whatever is there, and some of what is there is common and incidental. Whether any of it matters depends entirely on whether it fits your symptoms.
What do the common phrases describe?
Reports use a fairly consistent vocabulary, and it is worth recognising what the phrases describe without reading too much into them.
Words such as degenerative change, disc desiccation, protrusion, herniation or nerve root impingement describe features seen on the image. They are observations about structure.
Here is the difficulty. Some of these features are common in people with no pain at all, and imaging findings of that sort have been shown to be widespread in people without symptoms.
So a report that describes a finding is not the same as a report that explains your pain, and the two are easy to confuse.
That is not a criticism of radiologists — describing what is there is exactly their job. It is why the report on its own rarely settles a question.
What should you do with it?
Take it to the person treating you, and ask the question it does not answer. Usually that is some variation of: is what is described here the reason for my symptoms, and if not, what does that leave?
It is also worth checking what the scan was actually for. If it was requested to answer a specific question, the report is a good answer to that question.
If the scan was arranged more generally, or a long time ago, the answer may not cover what you need now. A fresh look at the images by a radiologist is a different thing from a physiotherapy second opinion, and worth knowing about.
And if a finding has been sitting in your head as the reason for everything, it is reasonable to ask for it to be explained properly — by somebody who can put it together with the rest of your picture.
The bottom line
A scan report is a description of an image, not an explanation of your symptoms, and the difference is the whole point.
The questions worth taking to it are: what was this scan asked to find out, and does what it found actually account for what you are experiencing? If nobody has answered the second one, that is worth asking for.
When should you seek urgent help?
Seek urgent medical assessment for rapidly worsening or potentially serious symptoms, significant trauma, new progressive weakness, a hot swollen joint with fever, numbness around your groin, buttocks or inner thighs, new difficulty passing urine or new loss of bladder control, new loss of bowel control, new or worsening weakness in both legs, new difficulty starting or maintaining an erection, or if you are acutely unwell.
Project Sherlock is not an emergency or urgent-care service. If you think you may have an urgent medical problem, contact NHS 111, an appropriate urgent-care service or 999 in an emergency.
Please do not wait for a reply from us before seeking that help.