In Defence of Imaging: When Less Isn't More

Introduction: Don't Blame the Scan
​In recent years, a growing number of academic papers and social media narratives have raised concerns about rising imaging rates in musculoskeletal (MSK) care. The argument is familiar: imaging doesn’t help, causes harm, and fuels overmedicalisation by assigning labels that instill fear or lead to unnecessary interventions. (1, 2) 

Adding to the argument are studies showing that “abnormal” imaging findings such as disc degeneration or rotator cuff tears, are frequently present in people without symptoms. These findings are often used to recommend avoiding imaging in symptomatic individuals and to argue that similar findings in those with pain are often incidental or irrelevant.  (3-7) Some also claim that routine imaging fails to improve outcomes like pain, function, or satisfaction.(8) Taken together, these messages have driven a narrative that imaging is overused, harmful, and clinically invalid and should therefore be broadly avoided.(4)

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