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The MRI Scan That Cost A 17-Year-Old $6.5 Million

July 29, 2014
Written by: , Filed in: Musculoskeletal Radiology
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An MRI scan apparently cost a San Diego teenager $6.5 million earlier this month. The youngster, 17-year-old Brady Aiken, graduated this spring from San Diego’s Cathedral Catholic High School, where he pitched on the baseball team. He pitched so well, in fact, he pitched that the Houston Astros made him the very first pick in Major League Baseball’s annual First-Year Player Draft.

Aiken and the Astros agreed on a contract with a $6.5 million signing bonus. All that remained before the agreement would be concluded was a physical exam, including the fateful MRI scan of Aiken’s left elbow. (He throws left-handed.)

HIPAA regulations prevent anybody from speaking officially, but apparently the Astros saw an abnormality in that MRI that scared them. They withdrew their contract proposal and submitted a new offer of about $3.1 million. Aiken balked. When baseball’s July 18 deadline for signing draft picks passed, he was left with no contract at all. You can read the full story, including the details of baseball’s convoluted draft bonus rules, in a Sports Illustrated story published last week.

Reportedly, the MRI revealed something worrisome about Aiken’s ulnar collateral ligament (UCL), the ligament involved in the so-called Tommy John reconstructive surgery that so many baseball pitchers undergo. Joshua S. Dines, MD, an orthopedic surgeon and sports medicine specialist who is not one of the five doctors reported to have consulted with Aiken, told Sports Illustrated that the issue may not be with the ligament itself:

When I read the reports about Aiken, I thought that there might be some concern about the bony anatomy where the ligament attaches, perhaps the medial epicondyle. If that is damaged or abnormal, you’re left with less bone there to reconstruct the ligament, and that can mean that a reconstruction won’t always work.

Dr. Dines is a member of the Sports Medicine and Shoulder Service at the Hospital for Special Surgery in New York.

Reports also have indicated that Aiken’s UCL may be abnormally small, although there’s no research about whether a smaller ligament is necessarily weaker. MedPage Today looked at the issue last week. Aiken, who turns 18 on August 16, says he feels no pain when he pitches. In his last high school game, his fastball reached 97 mph. Few major leaguers can throw that hard.

So where does that leave the young man? On his way to study and pitch at UCLA. Except that, according to the Houston Chronicle, his complicated and acrimonious negotiations with the Astros may have jeopardized his college eligibility.

Related CME seminar (up to 13.25 AMA PRA Category 1 credits™): UCSF Musculoskeletal MR Imaging

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