MRIs - The Positives and the False Positives

Tests – what are they good for?

When it comes to back pain tests, of MRIs that question must be examined. What are MRIs good for when the proportion of useful, influential MRI studies is so little? False positive MRI results distress those who get such results. They inspire fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Most Chiropractic Clinic carefully weighs the necessity of MRI in the Murfreesboro chiropractic treatment plan of Murfreesboro back pain relief.

MEDICINE’S VIEW

MRI interpretations by radiologists often differ.  The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may trigger false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% found anything suspicious. Of the 36 MRIs that provoked 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 misinform. For example, MRI shows 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Most Chiropractic Clinic, to compare all such findings to patient symptoms. (1,3) Your Murfreesboro chiropractor does this!

CHIROPRACTIC’S VIEW

Choosing Wisely guidelines for American chiropractors suggest30 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 efficacy of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms reported that there is very low risk of missing a worrying cause of back pain. (5) The purpose of guidelines is less imaging, fewer false positives.  Most Chiropractic Clinic wants what’s best for our Murfreesboro chiropractic care patients.

COX® TECHNIC’S VIEW

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

CONTACT Most Chiropractic Clinic

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 Murfreesboro chiropractic appointment with Most Chiropractic Clinic today. Let us explore together the best path to Murfreesboro back pain relief – with or without MRI imaging!