Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
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 NICE NG234.
- Suspected primary brain tumours or brain metastases, where standard structural MRI is the initial diagnostic test unless contraindicated NICE NG99.
- New or changing neurological symptoms or signs suggestive of glioma or other brain tumours, warranting MRI for diagnosis or monitoring NICE NG99.
- 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 NICE NG220.
- Any urgent neurological symptoms that require immediate diagnosis to start treatment, potentially justifying overnight MRI NICE NG234.
In addition, MRI is preferred over plain X-rays for spinal pathology and should be considered when CT is contraindicated or insufficient NICE NG234. Referral for MRI should be made when clinical features suggest serious underlying pathology requiring detailed imaging for diagnosis and management planning.