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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 asked. What are MRIs good for when the proportion of useful, influential MRI studies is so minor? False positive MRI results upset those who get these results. They arouse fear or caution where it is not always warranted. MRIs like this blur the proper treatment plan. They spend a lot of money. Mandeville Chiropractic carefully weighs the necessity of MRI in the Mandeville chiropractic treatment plan of Mandeville 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 cause false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% uncovered 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 demonstrates that the appearance 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Mandeville Chiropractic, to correlate all such findings with patient symptoms. (1,3) Your Mandeville chiropractor does this!

CHIROPRACTIC’S VIEW

Choosing Wisely guidelines for American chiropractors recommend not repeating spinal imaging and not obtaining 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 indicate something more sinister). (4) A review of the efficacy 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 goal of guidelines is less imaging, fewer false positives.  Mandeville Chiropractic wants what is best for our Mandeville chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Mandeville Chiropractic study all the symptoms, tests and images our Mandeville chiropractic back pain patients [[present on|bring with them39] their first Mandeville chiropractic visit. So many back pain patients present to Mandeville Chiropractic with MRI images already in-hand. Mandeville Chiropractic will look at them but will rely 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 work toward 50% decrease of back pain in the first month of care before arranging more imaging or testing or referring for surgical consultation. (6)

CONTACT Mandeville Chiropractic

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

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

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