What are the key indications for referring a patient for an MRI scan in primary care?

Key indications for referring a patient for an MRI scan in primary care include:

• Clinical suspicion of spinal metastases without signs of metastatic spinal cord compression (MSCC), where MRI should be performed within 1 week to guide treatment options ¹.
• Suspected primary brain tumours or brain metastases, where standard structural MRI is the initial diagnostic test unless contraindicated ².
• New or changing neurological symptoms or signs suggestive of glioma or other brain tumours, warranting MRI for diagnosis or monitoring ².
• Suspected multiple sclerosis (MS) based on neurological symptoms such as visual loss, double vision, sensory disturbances, or progressive balance difficulties, after excluding alternative diagnoses and confirming a neurological episode ³.
• Any urgent neurological symptoms that require immediate diagnosis to start treatment, potentially justifying overnight MRI ¹.

In addition, MRI is preferred over plain X-rays for spinal pathology and should be considered when CT is contraindicated or insufficient ¹. Referral for MRI should be made when clinical features suggest serious underlying pathology requiring detailed imaging for diagnosis and management planning.