BMJ Open Qual July 2021 PMID 34215659

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care.

Imran Mohammed Sajid, Anand Parkunan, Kathleen Frost

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Mentions

69
Peak: 15 in Aug 2025
across 6 sources since Jul 2021

Extended reach

749,869
potential audience

Total likes

173

Video views

404

Mentions per month

Jul 2021 – Sep 2025

Where it's discussed

  • X / Twitter56 posts
  • Facebook4 posts
  • Blogs3 articles
  • YouTube2 videos
  • Reddit2 posts
  • News2 articles

AI synopsis

What people are saying

The collective analyses reflect a recognition that unnecessary MRIs can cause harm and incur costs, with examples like calls to 'stop contributing to chronic pain' and notes about how many MRI requests were unnecessary, illustrating moderate agreement and engagement. The tone and wording—such as 'eye-opening' and 'unintended consequences'—highlight the perceived significance of the findings, contributing to a thoughtful and cautious discourse.

AgreementModerate agreement

Most discussions acknowledge the findings of the publication, emphasizing the potential harms of unnecessary MRI use, indicating agreement with its conclusions.

InterestModerate interest

Posts show moderate interest, with some emphasizing the importance of cautious imaging practices but not deeply exploring alternative solutions.

EngagementHigh engagement

Many comments actively reference specific aspects of the study, such as the cascade costs and the high rate of inappropriate requests, reflecting thoughtful engagement.

ImpactModerate impact

The discussions suggest that the publication could influence clinical practice by raising awareness about overuse and downstream harms, though some focus more on criticism than impact.

Abstract in brief

  • Many patients received only anatomical explanations based on age or activity, with limited consideration of mental health or psychosocial factors. - There was a high rate of misinterpretation of MRI results by GPs, resulting in low-value, harmful, or unnecessary follow-up procedures and referrals, with MRI-triggered referrals rarely leading to definitive treatments.
  • This overdiagnosis and misdiagnosis caused delays in appropriate care and increased cascade costs significantly beyond the direct expense of MRI imaging. - Overall, the findings highlight the need for improved practices and guidelines in primary care to ensure appropriate MRI use, better interpretation, and holistic patient management to reduce downstream harms and costs.]

Top posts

Most liked on X and Bluesky
The Sp⚽️rts Physio
@AdamMeakins · X

Many patients with MSK issues don’t recover as expected due to iatrogenic and socioeconomical factors! Before we START trying to find better treatments for chronic pain we need to first STOP contributing to it! https://t.co/9JhiQSx321 https://t.co/ZqXbQcfjaB

Jun 4, 2024 · 58 likes · 4 shares · 107,649 followers View post →
The Sp⚽️rts Physio
@AdamMeakins · X

MRI HARMS > HELPS Next a eye opening paper highlighting how unnecessary routine MRIs can cause more harm than good for many people! 5/10 https://t.co/9JhiQSwvct

Dec 30, 2021 · 20 likes · 2 shares · 107,649 followers View post →
ɹǝʇlnoԀ pıʌɐᗡ
@Retlouping · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/706BEiQON0 https://t.co/mWstQ6mJnt

Sep 21, 2021 · 20 likes · 7 shares · 26,213 followers View post →
Ash Paul
@pash22 · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/n6My9hKzFB via @aparkunan et al https://t.co/0vWuK10Kv7

Aug 3, 2025 · 19 likes · 7 shares · 32,256 followers View post →
ɹǝʇlnoԀ pıʌɐᗡ
@Retlouping · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/QDoaEUbM4V https://t.co/0nZi0g7OW5

Aug 2, 2025 · 14 likes · 8 shares · 26,213 followers View post →
Teppo Järvinen
@shamteppo · X

Access to MRI in primary care (GP) for MSK patients? Sounds like a great idea, doesn't it? Early, definite diagnosis => improved care! However... Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs... https://t.co/Z3d7oa2Tby

Jul 7, 2021 · 10 likes · 1 share · 1,108 followers View post →

All mentions

ɹǝʇlnoԀ pıʌɐᗡ
@Retlouping · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Sep 22, 2025 · 8 shares · 26,213 followers View post →
octavio
@dontavo66 · X

RT @pash22: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK p…

Aug 4, 2025 · 7 shares · 330 followers View post →
Hematology Media Center (HMC)
@US_HMC · X

RT @pash22: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK p…

Aug 3, 2025 · 7 shares · 270 followers View post →
Сергей Валентинович
@ssvnauka · X

RT @pash22: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK p…

Aug 3, 2025 · 7 shares · 211 followers View post →
priya joseph
@ayirpelle · X

RT @pash22: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK p…

Aug 3, 2025 · 7 shares · 4,911 followers View post →
Madhan Ramanathan
@sportsphysiouk · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Aug 3, 2025 · 8 shares · 1,090 followers View post →
Shibata Masashi@GP×EBM
@EbmShibanyan · X

RT @pash22: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK p…

Aug 3, 2025 · 7 shares · 1,683 followers View post →
Rafeeq
@rafeeq_rm · X

RT @pash22: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK p…

Aug 3, 2025 · 7 shares · 1,185 followers View post →
Rob Setters
@RobSetters · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Aug 3, 2025 · 8 shares · 276 followers View post →
strain_rate
@strain_rate · X

RT @pash22: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK p…

Aug 3, 2025 · 7 shares · 5,520 followers View post →
Ash Paul
@pash22 · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/n6My9hKzFB via @aparkunan et al https://t.co/0vWuK10Kv7

Aug 3, 2025 · 19 likes · 7 shares · 32,256 followers View post →
Koushik
@koushikphysio · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Aug 3, 2025 · 8 shares · 519 followers View post →
Rachiphile
@joshlavalleeMK · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Aug 3, 2025 · 8 shares · 1,800 followers View post →
Daniel Godeassi
@dangodeassi · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Aug 2, 2025 · 8 shares · 203 followers View post →
Andre
@drandrefkunpad · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Aug 2, 2025 · 8 shares · 39 followers View post →
ɹǝʇlnoԀ pıʌɐᗡ
@Retlouping · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/QDoaEUbM4V https://t.co/0nZi0g7OW5

Aug 2, 2025 · 14 likes · 8 shares · 26,213 followers View post →
Bad Putty Tat
@BadPutty · X

RT @1kilroywashere: 2021 Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeleta…

Dec 5, 2024 · 2 shares · 2,671 followers View post →
Wheelie MS Advocate - #CareNotCuts - ♿️
@WheelieFUMS · X

RT @1kilroywashere: 2021 Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeleta…

Dec 5, 2024 · 2 shares · 3,443 followers View post →
Kilroy Was Here
@1kilroywashere · X

2021 Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/xdgcLb9mmU @drbobgill @paulapeters2 @WheelieFUMS @SusanChubb1 @DPACSheffield @vamroses @irisstylosa @BadPutty

Dec 5, 2024 · 2 shares · 3,454 followers View post →
Daniel Godeassi
@dangodeassi · X

RT @AdamMeakins: Many patients with MSK issues don’t recover as expected due to iatrogenic and socioeconomical factors! Before we START tr…

Jun 4, 2024 · 4 shares · 203 followers View post →
ChrisMatsias
@cmphysio · X

RT @AdamMeakins: Many patients with MSK issues don’t recover as expected due to iatrogenic and socioeconomical factors! Before we START tr…

Jun 4, 2024 · 4 shares · 229 followers View post →
Paul Adamson
@FfisioPaul · X

RT @AdamMeakins: Many patients with MSK issues don’t recover as expected due to iatrogenic and socioeconomical factors! Before we START tr…

Jun 4, 2024 · 4 shares · 83 followers View post →
Will king
@King2980 · X

RT @AdamMeakins: Many patients with MSK issues don’t recover as expected due to iatrogenic and socioeconomical factors! Before we START tr…

Jun 4, 2024 · 4 shares · 648 followers View post →
Teemu Ripatti
@tripatti89 · X

https://t.co/KONJ9Vef48

Jun 4, 2024 · 13 followers View post →
The Sp⚽️rts Physio
@AdamMeakins · X

Many patients with MSK issues don’t recover as expected due to iatrogenic and socioeconomical factors! Before we START trying to find better treatments for chronic pain we need to first STOP contributing to it! https://t.co/9JhiQSx321 https://t.co/ZqXbQcfjaB

Jun 4, 2024 · 58 likes · 4 shares · 107,649 followers View post →
The Sp⚽️rts Physio
@AdamMeakins · X

Many patients with MSK issues don’t recover as expected due to iatrogenic and socioeconomical factors! Before we START trying to find better treatments for chromic pain we need to first STOP contributing to it! https://t.co/9JhiQSx321 https://t.co/ZqXbQcfjaB

Jun 4, 2024 · 1 like · 107,649 followers View post →
Hung Tran
@metropoly · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Oct 22, 2023 · 7 shares · 19 followers View post →
ɹǝʇlnoԀ pıʌɐᗡ
@Retlouping · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Oct 22, 2023 · 7 shares · 26,213 followers View post →
Stephen
@StephenRoss43 · X

RT @adamdobson123: 2️⃣ THE PROBLEM. 1-4 patients with LBP are referred for imaging https://t.co/KWonP9NsYp Of 306 MSK-MRI requests only 4…

Jan 29, 2023 · 3 shares · 286 followers View post →
Austin Baraki, MD
@AustinBaraki · X

RT @adamdobson123: 2️⃣ THE PROBLEM. 1-4 patients with LBP are referred for imaging https://t.co/KWonP9NsYp Of 306 MSK-MRI requests only 4…

Jan 25, 2023 · 3 shares · 4,892 followers View post →
Cian
@cdoyle3 · X

RT @adamdobson123: 2️⃣ THE PROBLEM. 1-4 patients with LBP are referred for imaging https://t.co/KWonP9NsYp Of 306 MSK-MRI requests only 4…

Jan 25, 2023 · 3 shares · 205 followers View post →
Adam Dobson
@adamdobson123 · X

2️⃣ THE PROBLEM. 1-4 patients with LBP are referred for imaging https://t.co/KWonP9NsYp Of 306 MSK-MRI requests only 4.9% were indicated and only 1.3% lead to change in management https://t.co/RJxza7NBdL

Jan 25, 2023 · 8 likes · 3 shares · 12,604 followers View post →
ɹǝʇlnoԀ pıʌɐᗡ
@Retlouping · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/706BEj8Y18 https://t.co/RGxkm1wO4B

Nov 30, 2022 · 1 like · 26,213 followers View post →
Choosing Wisely Brasil
@ChooseWiselyBR · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/o8VRX6ptAW

Sep 1, 2022 · 1 like · 3,875 followers View post →
Paul Schofield
@PaulSkoder · X

@ThomasRoth91 Careful with the GP bashing, cannot understate difficulty in addressing ICE in often <10mins. However as per paper below we know primary care MSK MRI doesn’t “work” this is why locally cannot request MRI (Cambridgeshire) https://t.co/YIotAX2SCb

Feb 9, 2022 · 1 like · 49 followers View post →
John Wilson
@jwilsonphysio · X

RT @AdamMeakins: MRI HARMS > HELPS Next a eye opening paper highlighting how unnecessary routine MRIs can cause more harm than good for ma…

Feb 8, 2022 · 2 shares · 36 followers View post →
Stephen Guy
@kneeguyuk · X

RT @AdamMeakins: MRI HARMS > HELPS Next a eye opening paper highlighting how unnecessary routine MRIs can cause more harm than good for ma…

Jan 3, 2022 · 2 shares · 1,606 followers View post →
The Sp⚽️rts Physio
@AdamMeakins · X

MRI HARMS > HELPS Next a eye opening paper highlighting how unnecessary routine MRIs can cause more harm than good for many people! 5/10 https://t.co/9JhiQSwvct

Dec 30, 2021 · 20 likes · 2 shares · 107,649 followers View post →
Greta Compton Dip DH RCSEd aka Gretsky
@Gretsky_Compton · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care | BMJ Open Quality https://t.co/tUhEQefsJc

Dec 27, 2021 · 902 followers View post →
panagiotis griveas
@PGriveas · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Dec 19, 2021 · 1 share · 46 followers View post →
ɹǝʇlnoԀ pıʌɐᗡ
@Retlouping · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/706BEj8qbA https://t.co/eOli5Ks2tP

Dec 19, 2021 · 9 likes · 1 share · 26,213 followers View post →
Daniel Kawka
@KawkaDaniel · X

[5/5] Źródło: Sajid IM, Parkunan A, Frost K Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care BMJ Open Quality 2021;10:e001287

Dec 9, 2021 · 744 followers View post →
Ash Paul
@pash22 · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary car https://t.co/tUSOHVwJ5J via @imransajid et al

Nov 24, 2021 · 2 likes · 32,256 followers View post →
Will Bostock
@DrWBostock · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/0q5hCebe5Q

Nov 9, 2021 · 134 followers View post →
Simon Everett
@sdephysio · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Sep 22, 2021 · 7 shares · 403 followers View post →
Matthew Wyatt
@MRWPhysio · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Sep 22, 2021 · 7 shares · 3,299 followers View post →
Prof. Ian Horsley
@Back_in_Action · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Sep 22, 2021 · 7 shares · 11,828 followers View post →
Juanjo Fernández
@juanjofer96 · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Sep 22, 2021 · 7 shares · 496 followers View post →
Toby Hall
@DrTobyHall · X

RT @Retlouping: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in…

Sep 22, 2021 · 7 shares · 5,581 followers View post →
ɹǝʇlnoԀ pıʌɐᗡ
@Retlouping · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/706BEiQON0 https://t.co/mWstQ6mJnt

Sep 21, 2021 · 20 likes · 7 shares · 26,213 followers View post →
The Sp⚽️rts Physio
@AdamMeakins · X

@drdavidevans So no citation then… and you clearly are unaware of both the benefits and issues with early imaging for all types of LBP so let me help you out with a few papers you should read! https://t.co/9JhiQSwvct https://t.co/WUPQMpRNor https://t.co/jCyXix5g2t

Aug 17, 2021 · 107,649 followers View post →
Used to be disgusted
@drbknight · X

RT @LessIsMoreMed: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI…

Aug 16, 2021 · 2 shares · 1,181 followers View post →
John Haggie
@Johnrockdoc · X

RT @LessIsMoreMed: Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI…

Aug 16, 2021 · 2 shares · 17,764 followers View post →
GLA:D Back Canada
@GLADBackCanada · X

More about why imaging can be harmful….https://t.co/kAOPAHEHFc

Aug 13, 2021 · 4 likes · 58 followers View post →
Teppo Järvinen
@shamteppo · X

Access to MRI in primary care (GP) for MSK patients? Sounds like a great idea, doesn't it? Early, definite diagnosis => improved care! However... Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs... https://t.co/Z3d7oa2Tby

Jul 7, 2021 · 10 likes · 1 share · 1,108 followers View post →
SWBH Library
@SWBHLibrary · X

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care https://t.co/KM6FQqZW7I latest original research from @BMJOpenQuality @SWBHnhs https://t.co/4k5OpGWcHq

Jul 5, 2021 · 1 like · 729 followers View post →