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 helpful, influential MRI studies is so minor? False positive MRI results upset those who receive these results. They arouse fear or caution where it’s not always needed. MRIs like this blur the proper treatment plan. They spend a lot of money. Wilson Family Chiropractic carefully evaluates the need for MRI in the Millville chiropractic treatment plan of Millville back pain relief.

MEDICINE’S VIEW

MRI interpretations by radiologists often vary.  The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may trigger 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 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 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Wilson Family Chiropractic, to link all such findings with patient symptoms. (1,3) Your Millville 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 suggest something more worrisome). (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.  Wilson Family Chiropractic wants what is best for our Millville chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Wilson Family Chiropractic study all the symptoms, tests and images our Millville chiropractic back pain patients [[present on|bring with them39] their first Millville chiropractic visit. So many back pain patients come to Wilson Family Chiropractic with MRI images already with them. Wilson Family Chiropractic will look at them but will rely 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 month of care before arranging additional imaging or testing or referring for surgical consultation. (6)

CONTACT Wilson Family 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 scheme of treatment for pain relief.

Schedule your Millville chiropractic appointment with Wilson Family Chiropractic today. Let’s explore together the best path to Millville back pain relief – with or without MRI imaging!