Determining the appropriateness of requests for outpatient magnetic resonance imaging of the hip

Summary: In Ontario, Canada, wait times for magnetic resonance imaging (MRI) scans continue to exceed provincial targets. We sought to determine the incidence of inappropriate hip MRI scan referrals, based on accepted indications for hip MRI. We developed an algorithm to appraise each MRI referral based on a prescan patient questionnaire and the interpretation of the MRI by a musculoskeletal radiologist. After reviewing 84 patient questionnaires, we considered 32.1% of MRI referrals to be inappropriate; 25.9% of the inappropriate MRI referrals were ordered as a preoperative test for potential hip arthroscopy despite the patients showing severe osteoarthritis. Having no prior radiographic examination was the most common reason for inappropriate referrals, regardless of pathology (48.1%). With limited MRI scanner time available in Ontario, it is essential that guidelines and training be improved on the indications for hip MRI to reduce the wait times for these specialized tests.