Is it valuable to get an MRI on both feet? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
There are a few occasions when you might want to get an MRI on both feet. Truthfully, it is not easy to do. I once had a runner who was training for marathons, he was super fit, he went for a long, super steep run in Yosemite and caused some damage to both of the tendons in his feet, the same tendons, and he really did need an MRI on both feet.
I wrote an order for it, they tried to get prioritization, and this guy who actually works for the insurance company basically denying claims, he said, “You’re not going to get an MRI on both feet. We’re not doing it until you do x-rays and then you’re only going to get one.” And that doesn’t make any sense to me, but that’s the way insurance companies work sometimes, you have to work around that.
But the point is, the guy had a bona fide injury that really did warrant an MRI on both feet, it was medically necessary, and yet the insurance company still denied it. Well, if that happens, you always have the option of paying for it. Most people don’t want to do that, but that is your option if they deny it. Now, that’s an obvious one. So he had injuries on both feet, he needed MRIs on both feet to really assess the problem.
We could have done an ultrasound or something else, but given where he was and he was out of town, getting the MRI was the best option for him. Now, the other thing is that there are times when it could be useful when you’re actually not injured on the other side. Now, I recently did a remote consultation, a video cam visit with someone that’s out of the country. It’s not in the United States, rules are different. So in his country, actually they have universal healthcare, basically everything’s included.
He had months of treatment, months of evaluation, and then his doctor ordered an MRI, and when he went to get the MRI, they actually did both feet so they could compare. Now, this was fascinating to me because I have never ever had a patient who just went and was given both MRIs, even on the non-injured side to compare to the injured side. But it was really interesting and it was incredibly useful because as we’re going through his images, going through both MRIs, side by side, on his webcam visit, while I was doing it by a screen share, so that he could actually see what was going on in the tendons. Even if you don’t know how to read them, even if you’re not a radiologist or a foot surgeon, if you see the damage on one side versus what looks like normal on the other side, it really makes it clear how extensive the problem is.
This was one episode where it was incredibly helpful to see, and I really wish that more people had them when they had these tendon injuries and you’re not sure how much it really matters. Because if you compare your right side to your left side, you’re getting a real apples to apples comparison on what it should be. And when you get MRIs on both feet, it’s kind of like a second opinion, it just gives you a totally different perspective, and it can be really helpful to help you figure out what’s going to be most necessary for you to make the right decision, pick the right course of treatment, and get back to running as quickly as possible.
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