Posted on 21 August 2002
Every year 15 per cent of the patients who consult their GP are there because they have problems with their bones or joints. Sometimes they will need surgery, sometimes this can be avoided. But an accurate diagnosis is essential to decide whether an operation is necessary or whether other treatment such as physiotherapy could be more appropriate.
Now researchers at the University of York are looking at the ways in which patients with knee problems are diagnosed and managed, and whether the latest technology - medical resonance imaging or MRI - can arm GPs with better information. The Department of Health Sciences at York has been awarded £611,400 to examine the problem.
Some GPs opt to use MRI to assess all cartilage or ligament injuries. MRI is quick and accurate. It can avoid using expensive keyhole surgery unnecessarily, helping to cut queues, and its use by GPs in primary health care is growing.
However, there has been no evaluation yet of whether patients= quality of life is better when GPs have used MRI and then worked out treatment accordingly, rather than making a referral immediately to a hospital specialist. There is a wide variation in GPs= access to MRI, the amount they use the technology, and the associated costs.
The Medical Research Council has now funded the four-year randomised trial by the University of York to assess objectively whether patients who see go their GPs with continuing knee problems should have an MRI scan or be referred directly to an orthopaedic surgeon. The study will also give GPs information about the most appropriate use of MRI and how to interpret findings.
Five hundred patients will be recruited from 250 general practices in North Yorkshire, North Wales and North East Scotland, and followed up over 24 months.
Professor Ian Russell, of the Department of Health Sciences, said: ‘This is a major opportunity to collect rigorous evidence on the role of MRI in primary care. It will also help to improve communications and collaboration between health care professionals.'