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 questioned. What are MRIs good for when the proportion of helpful, influential MRI studies is so little? False positive MRI results distress those who receive such results. They arouse fear or caution where it is not always warranted. MRIs like this confuse the proper treatment plan. They cost quite a bit. Apple Country Chiropractic carefully weighs the necessity of MRI in the Williamson chiropractic treatment plan of Williamson 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 cause misleading 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 raised 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 – 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Apple Country Chiropractic, to correlate 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 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 disturbing). (4) A review of the effectiveness 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 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 done. Apple Country Chiropractic 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 30 days of care before arranging more imaging or testing or referring for 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 explains the role of imaging for back pain in the program of treatment for pain relief.
Schedule your Williamson chiropractic appointment with Apple Country Chiropractic today. Let’s explore together the best path to Williamson back pain relief – with or without MRI imaging!
