In spine magnetic resonance imaging (MRI), incidental abnormalities are difficult to distinguish from actual pain generators (the cause of symptoms). Spine specialists see patients face to face and take clinical histories to learn symptoms. They use this symptom information to focus on only the most relevant MRI abnormalities, diagnose pain generators, and make treatment decisions. In the absence of symptom information, radiologists seek to identify all MRI abnormalities and list them in dictated reports without ranking their relative importance.

Like spine specialists, radiologists can match symptoms with MRI findings to improve diagnostic accuracy and confidence. Symptom-MRI correlation requires radiologists to have access to high-quality clinical information and understand the causal relationships between symptoms and pain generators. This article covers symptom-MRI correlation and pitfalls related to spine MRI interpretation.

Received: 29 January 2026

Accepted: 04 February 2026

Article published online:
16 March 2026

© 2026. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA