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 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 cost quite a bit. Apple Country Chiropractic carefully evaluates the necessity of MRI in the Williamson chiropractic treatment plan of Williamson 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 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 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 presence of disc degeneration in asymptomatic persons – persons with no back pain – rises 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 Apple Country Chiropractic, to link all such findings to patient symptoms. (1,3) Your Williamson 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 indicate 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 worrying cause of back pain. (5) The objective of guidelines is less imaging, fewer false positives.  Apple Country Chiropractic wants what’s best for our Williamson chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Apple Country Chiropractic review all the symptoms, tests and images our Williamson chiropractic back pain patients [[present on|bring with them39] their first Williamson chiropractic visit. So many back pain patients present to Apple Country Chiropractic with MRI images already in-hand. Apple Country Chiropractic will study 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 month of care before arranging additional imaging or testing or arranging surgical consultation. (6)

CONTACT Apple Country 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 Williamson chiropractic appointment with Apple Country Chiropractic today. Let us discover together the best path to Williamson back pain relief – with or without MRI imaging!

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