An MRI report describes what the scanner scanned and picked up – it does not say what is causing your pain, and the two are not the same thing.
Scans of people with NO symptoms routinely show tears, cysts, fluid and degeneration. So the finding on your report only matters if it matches where you hurt and what makes it hurt.
Here is what the words usually mean.
The vocabulary, translated
- Oedema, or increased signal. Fluid in a tissue. Fluid means something is irritated, bruised or inflamed. It says nothing about how bad
- Bone marrow oedema. Fluid inside the bone. Seen in stress reactions, recent impact and active arthritis. Often the most clinically useful line in the whole report
- Tendinosis. A tendon that has degenerated rather than torn. Extremely common with age and not necessarily your problem
- Partial thickness tear. Some fibres intact. Usually managed without surgery
- Effusion. Fluid in a joint. A response, not a diagnosis
- Degenerative change. Wear. Present in most hands after fifty and often painless
- Correlate clinically. The radiologist is telling your clinician that the picture needs a person attached to it before it means anything
Which scan answers which question
- X-ray. Bone. Fast, cheap, and the right first test for fractures and arthritis. Blind to tendon, ligament and nerve. A normal X-ray does NOT mean a normal wrist — see scaphoid fracture and scapholunate injury
- Ultrasound. Soft tissue, in real time, while you move. The best test for a tendon that snaps or subluxes, for trigger finger, and for guiding an injection. Depends heavily on who is holding the probe
- MRI. Everything at once, in still images. Best for bone marrow, cartilage, ligaments and tumours. Expensive, and it finds things that were never the problem
- CT. Bone detail. The test that confirms whether a scaphoid has united, which plain X-ray often cannot
- Arthrogram. Dye injected before the scan to show up small tears in the TFCC and interosseous ligaments
The scan finds findings. Only the examination finds the diagnosis. A report that doesn’t match your symptoms is describing someone’s anatomy, not their problem.
How to read your own report in four steps
- Read the conclusion first. The body of the report describes everything; the conclusion is what the radiologist thinks matters
- Check the side. Left and right get transposed more often than anyone likes to admit
- Mark where each finding is. If the finding is on the thumb side and your pain is on the little-finger side, that finding is not your answer
- Count the findings. Three or four incidental degenerative notes on one wrist is normal for an adult, not a catastrophe
The single most common harm I see from imaging is not a missed diagnosis. It is a person who has stopped using a perfectly good hand because a report used the word “tear”.
When a scan is genuinely worth having
- The result would change what happens next — surgery, or not
- A fracture is suspected and the X-ray is normal
- Symptoms don’t fit the examination and something is being missed
- There is a lump that needs characterising — see giant cell tumour and enchondroma
- Infection or a tumour is a possibility
And when it isn’t: a scan ordered to reassure you will often do the opposite, because it will find something. If nobody can tell you what they would do differently based on the result, the scan is not answering a question.
What to ask about your report
- Which of these findings explains my symptoms?
- Which are incidental?
- Would you expect to see these in someone my age with no pain?
- Does this change the plan?
A scan is a photograph of a moment, read by someone who has never met your hand.
It is potential evidence, but not a verdict.
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.