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 examined. What are MRIs good for when the percentage of useful, influential MRI studies is so small? False positive MRI results trouble 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 cost quite a bit. Pure Chiropractic carefully evaluates the need for MRI in the Concord, NC chiropractic treatment plan of Concord, NC 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 false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% revealed 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 – 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Pure Chiropractic, to compare all such findings with patient symptoms. (1,3) Your Concord, NC 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 indicate something more disturbing). (4) A review of the success 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 goal of guidelines is less imaging, fewer false positives. Pure Chiropractic wants what is best for our Concord, NC chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Pure Chiropractic review all the symptoms, tests and images our Concord, NC chiropractic back pain patients [[present on|bring with them39] their first Concord, NC chiropractic visit. So many back pain patients present to Pure Chiropractic with MRI images already with them. Pure Chiropractic will look at them but will rely more on clinical exam findings and link 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 30 days of care before arranging additional imaging or testing or arranging surgical consultation. (6)
CONTACT Pure 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 Concord, NC chiropractic appointment with Pure Chiropractic today. Let’s explore together the best path to Concord, NC back pain relief – with or without MRI imaging!
