To read your MRI report, go straight to the "Impression" at the end, which summarizes the radiologist’s main findings, then use the "Findings" section and a glossary to decode the terms. Words such as bulge, degeneration and desiccation are common in people with no pain at all: a 2015 review in the American Journal of Neuroradiology found disc degeneration in 37 percent of pain-free 20-year-olds and 96 percent of pain-free 80-year-olds. What matters is whether a finding matches your symptoms and examination, a question for the clinician who ordered the scan and your physical therapist.
Last reviewed By the Monon Therapy Collective editorial team
- Read first
- The Impression, at the end of the report
- Disc bulge without pain
- 30% at age 20, 84% at age 80 (AJNR 2015)
- Who explains it
- The clinician who ordered the scan
- Key question
- Does this finding match my symptoms?
What are the four parts of an MRI report?
Most MRI reports follow the same order: the clinical history or reason for the scan, the technique used, the findings described area by area, and an impression that summarizes what the radiologist thinks is important. A radiologist, a physician trained to interpret imaging, reads the scan and writes the report primarily for the clinician who ordered the test.
The technique section lists the image sequences and whether contrast dye was given; MedlinePlus notes the most common MRI contrast is gadolinium. The findings section walks through each level of the spine or each structure of a joint in technical shorthand. The impression is short, ranked by importance and the part your doctor reads first. If the impression says "no acute abnormality" or lists mainly "degenerative changes", that is often reassuring even when the findings look alarming.
What do common spine MRI terms mean?
Most spine reports use a small vocabulary that describes how discs, joints and the spaces for nerves have changed. The table translates the terms you are most likely to see. Spine levels are named by vertebra: L4-L5 is the disc between the fourth and fifth lumbar vertebrae, and C5-C6 is in the neck.
| Term on the report | What it means | Often seen without pain? |
|---|---|---|
| Disc desiccation / degeneration | The disc has lost some water and height with age | Yes, very common |
| Disc bulge | The disc edge extends evenly beyond the vertebra, like a slightly flattened tire | Yes, very common |
| Protrusion | A focal disc bulge with a broad base | Often |
| Extrusion / sequestration | Disc material pushed further out, or a separated fragment | Less often; may relate to leg symptoms |
| Annular fissure (tear) | A crack in the disc’s outer ring, not an injury in the usual sense | Yes, common |
| Facet arthropathy | Arthritis-type wear in the small joints at the back of the spine | Yes, increases with age |
| Foraminal narrowing / stenosis | Less room where a nerve root exits the spine | Sometimes; matters if symptoms match that nerve |
| Central canal stenosis | Less room in the main spinal canal | Sometimes; see spinal stenosis |
| Spondylolisthesis | One vertebra has slipped forward on the one below, graded by amount | Sometimes |
| Modic changes | Changes in the bone next to a disc, typed 1 to 3 | Sometimes |
How common are scary-sounding MRI findings in people without pain?
Very common, and more so with age. A systematic review by Brinjikji and colleagues in the American Journal of Neuroradiology in 2015 pooled imaging of people who had no back pain and found disc degeneration in 37 percent of 20-year-olds rising to 96 percent of 80-year-olds, and disc bulges in 30 percent of 20-year-olds rising to 84 percent of 80-year-olds.
The authors concluded that many of these features are part of normal aging rather than signs of disease, and should be read in the context of a person’s symptoms. That is why a report full of "degenerative changes" can coexist with a back that responds well to exercise and time. It is also why the degenerative disc disease label sounds worse than what it usually describes.
What do knee and shoulder MRI terms mean?
Joint MRI reports describe tendons, ligaments, cartilage and fluid rather than discs, but they follow the same pattern of findings and impression. A handful of terms account for most of what people find confusing.
- Tendinosis or tendinopathy: a tendon has changed in structure from load over time, not an acute tear.
- Partial-thickness tear: a tear that does not go all the way through a tendon, common in rotator cuffs as people age; see rotator cuff injury.
- Full-thickness tear: a tear through the whole tendon; size and retraction are usually described.
- Degenerative meniscus tear: fraying or a tear in knee cartilage from wear, often managed without surgery.
- Chondromalacia or chondral thinning: softening or thinning of joint surface cartilage, graded by depth.
- Joint effusion: extra fluid in the joint, which can follow injury or irritation.
- Bone marrow edema: fluid in the bone, seen with bone bruises, stress reactions and arthritis.
Which findings on a report should prompt a quick call to the ordering clinician?
Call the clinician who ordered the scan promptly if the report mentions a possible fracture, mass, lesion, infection, cord compression or cauda equina compression, or if you have not heard back about a report that uses those words. Those findings need medical follow-up, sometimes urgently, before physical therapy.
Words like "recommend clinical correlation" or "follow-up imaging suggested" are not emergencies; they mean the radiologist wants the treating clinician to compare the images with your examination or check again later. If you have leg weakness, numbness around the groin, or bladder or bowel changes, do not wait for a report at all: those symptoms need emergency care.
What should I ask about my MRI results?
Ask which finding, if any, explains your symptoms, whether anything needs further tests or a specialist, and whether the report changes what you should or should not do. Bring the written report to the appointment so you can point to specific words.
- Which of these findings do you think is causing my pain, and which are normal for my age?
- Does the side and level of the finding match where my symptoms are?
- Is anything here a reason to avoid exercise or physical therapy?
- Do I need repeat imaging, and what would change the plan?
- Can you send a copy of the report to my physical therapist?
How does a physical therapist use an MRI report?
A physical therapist reads the report alongside a hands-on examination of movement, strength, reflexes and sensation, and gives more weight to what the examination shows. A disc protrusion on the left at L5-S1 matters if your symptoms run down the left leg in the pattern of that nerve; it matters much less if your pain is on the right.
Many people start therapy without imaging at all, and the MRI before physical therapy answer explains when a scan adds value. Who can order imaging in Indiana is covered on the can a physical therapist order an MRI page. If you already have a report and want help making sense of what to do next, the back pain questionnaire lets the matching team propose an independent therapist near Carmel; bring the report and images to the first visit. The herniated disc physical therapy page covers a common reason for a spine MRI.
Do not wait for an MRI report if you have
- Numbness around the groin or buttocks, or new bladder or bowel problems: call 911.
- Weakness in an arm or leg that is getting worse over hours or days.
- Back or neck pain with fever, unexplained weight loss or a history of cancer.
- Severe pain after a fall or car accident.
If you think it is an emergency, call 911.
