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 constructive, influential MRI studies is so minor? False positive MRI results upset those who receive such results. They inspire fear or caution where it’s not always warranted. MRIs like this blur the proper treatment plan. They spend a lot of money. New Roads Chiropractic Center carefully evaluates the need for MRI in the New Roads chiropractic treatment plan of New Roads back pain relief.

MEDICINE’S VIEW

Interpretations of MRI images by radiologists often vary.  The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may cause misleading 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 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 shows that the presence of disc degeneration in asymptomatic persons – persons with no back pain – increases 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 New Roads Chiropractic Center, to correlate all such findings with patient symptoms. (1,3) Your New Roads 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 sinister). (4) A review of the success of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms stated 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.  New Roads Chiropractic Center wants what’s best for our New Roads chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at New Roads Chiropractic Center review all the symptoms, tests and images our New Roads chiropractic back pain patients [[present on|bring with them39] their first New Roads chiropractic visit. So many back pain patients come to New Roads Chiropractic Center with MRI images already done. New Roads Chiropractic Center will look at them but will rely more on clinical exam findings and link them to what the MRI reveals. 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 arranging additional imaging or testing or arranging surgical consultation. (6)

CONTACT New Roads Chiropractic Center

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 program of treatment for pain relief.

Schedule your New Roads chiropractic appointment with New Roads Chiropractic Center today. Let us explore together the best path to New Roads back pain relief – with or without MRI imaging!