Upright versus recumbent lumbar spine MRI: do findings differ systematically, and which correlates better with pain? A systematic review

For most MRI parameters, the direction of the observed difference between assessment in recumbent and upright positions aligned with the prespecified expectation implied by the weight-bearing position. This confirms the existence of a systematic difference between the 2 positions. Performing an MRI upright instead of recumbent position may increase the correlation with pain, but final evidence for this property is still missing. The clinical significance of upright MRI is still unclear, and there is a need to directly investigate the impact of MRI findings on clinical decision-making and patient outcomes.