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MRIs - The Positives and the False Positives

Tests – what are they good for?

In the realm of back pain tests, of MRIs that question must be questioned. What are MRIs good for when the percentage of useful, influential MRI studies is so little? False positive MRI results distress those who get such results. They arouse fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They cost quite a bit. Chiropractic Care carefully evaluates the necessity of MRI in the Chicago chiropractic treatment plan of Chicago back pain relief.

MEDICINE’S VIEW

Interpretations of MRI images by radiologists often differ.  The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may produce misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% revealed anything that needed to be addressed. Of the 36 MRIs that caused suspicion of cancer or infection, 81% were false-positive. 59% of the follow-up MRIs on those suspicious findings were false positives. (2) MRI imaging may mislead. For example, MRI demonstrates that the presence of disc degeneration in asymptomatic persons – persons with no back pain – grows with age:  37% in 20 year olds and 96% in 80 year olds; disc bulges: 30% to 84%; disc protrusion: 29% to 43%; annular fissures 19% to 29%. These imaging findings indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Chiropractic Care, to link all such findings with patient symptoms. (1,3) Your Chicago chiropractor does this!

CHIROPRACTIC’S VIEW

Choosing Wisely guidelines for American chiropractors recommend not repeating spinal imaging and not getting spinal imaging for patients with acute low back pain in the first 6 weeks of back pain (except when “red flags” are present– issues that suggest something more worrisome). (4) A review of the success of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms reported that there is very low risk of missing a serious cause of back pain. (5) The purpose of guidelines is less imaging, fewer false positives.  Chiropractic Care wants what’s best for our Chicago chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Chiropractic Care study all the symptoms, tests and images our Chicago chiropractic back pain patients [[present on|bring with them39] their first Chicago chiropractic visit. So many back pain patients present to Chiropractic Care with MRI images already done. Chiropractic Care will look at them but will depend more on clinical exam findings and correlate them to what the MRI shows. A rule of thumb with the Cox Technic System of Back Pain Relief is to seek 50% decrease of back pain in the first 30 days of care before ordering additional imaging or testing or arranging surgical consultation. (6)

CONTACT Chiropractic Care

Listen to this PODCAST with Dr. Dan Clark on the Back Doctor’s Podcast with Dr. Michael Johnson as he explains the role of imaging for back pain in the scheme of treatment for pain relief.

Schedule your Chicago chiropractic appointment with Chiropractic Care today. Let’s discover together the best path to Chicago back pain relief – with or without MRI imaging!

 
Chiropractic Care carefully decides when and if MRI images are needed to guide the Chicago chiropractic treatment plan.  
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