Dr David McGrath

Spine Physician

Victim of Modern Imaging Technology

This expression was first used in 2003 by Richad Hayward. He was expressing the concern that people were receiving unecessary interventions based upon imaging findings.There is another expression conveying a similar meaning. BARF= "Brainless Application of Radiological Findings".
There is no doubt that modern CT and MRI scanners have added to our appreciation of structural pathology. Some imaging techniques,such as ultrasound, can also give dynamic information as well.

So what's the problem?
The issue lies in the interpretation and potentially invalid interventions based upon these findings. Doctors must strive to grasp the relevence of observations through carefully acquired knowledge. There are two main traps.

1.The reporting of findings can be wrong. The agreement between radiolgists may differ considerably,or worse they agree but suffer from the same bias. In other words reports are opinions not god given truth.

2.In the musculoskeltal area, the correlation between painful disability and imaging findings is low.

Which means,action based upon such data is likely to be invalid.

Without going into the maths, here's the bottom line.

You have "blah blah condition " may be incorrect AND even if you have "blah blah" it may have nothing to do with your problem.

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