Adjustments may need to be made when it comes to how radiologists review MRIs of MMA fighters with possible brain injuries.
Dr. Nitkin Sethi, a respected ringside physician, and neurologist in New York wrote an interesting letter to the Journal Neurology, discussing MRI findings that are often minimized by radiologists but could be concerning for combat sports athletes. When your physician orders an MRI they often don’t see the raw data generated. Instead, it is reviewed by a radiologist who authors a report summarizing what is observed.
Dr. Sethi noted that MRI reports he reviews for fighters often show FLAIR white matter hyperintensities. Treating radiologists often report these as nonspecific findings seen in fairly routine conditions such as migraines. When an athletic commission reviews a fighter’s MRI report for licensing purposes they will have no concerns if the treating radiologist expressed nothing of note.
Are possible brain injuries in MMA fighters being overlooked?
However, Dr. Sethi notes that in his years of experience with these findings, while consistent with other conditions, could also be a biomarker of concussive brain injuries. Appreciating this, Dr. Sethi notes that when these findings are made in combat sports athletes, treating and overseeing physicians should be aware of this and it should be a priority when counseling and prognosticating about brain health, CTE, and decisions about retirement.
Dr. Sethi’s letter reads as follows:
Medical experts weigh-in on reviews of MMA fighter MRIs
I shared this observation on Twitter where several other doctors and ringside physicians weighed in with the below worthwhile comments:
https://twitter.com/MGoodmanMD/status/1490842296648011782https://twitter.com/SamStellpflug/status/1490833478698827779https://twitter.com/SamStellpflug/status/1490836553811345409
The trillion-dollar question is when is an athlete about to cross the threshold of no return when it comes to too much career brain trauma and CTE? The answer is not known.
Until the answer is known, the smoking gun analogy is apt. Cigarettes are linked to cancer. How many you can smoke before getting the disease is an unknown number, one that varies for everyone. All that can be said for certain is less is better. The same can be said for hits to the head and CTE.
