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 constructive, influential MRI studies is so minor? False positive MRI results upset those who receive such results. They inspire fear or caution where it’s not always needed. MRIs like this blur the proper treatment plan. They cost quite a bit. Arctic Chiropractic, Sitka carefully evaluates the necessity of MRI in the Sitka chiropractic treatment plan of Sitka back pain relief.
MEDICINE’S VIEW
Interpretations of MRI images by radiologists often vary. The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may trigger false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% found anything that needed to be addressed. Of the 36 MRIs that roused 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 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 Arctic Chiropractic, Sitka, to compare all such findings to patient symptoms. (1,3) Your Sitka 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 sinister). (4) A review of the efficacy of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms reported 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. Arctic Chiropractic, Sitka wants what’s best for our Sitka chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Arctic Chiropractic, Sitka study all the symptoms, tests and images our Sitka chiropractic back pain patients [[present on|bring with them39] their first Sitka chiropractic visit. So many back pain patients present to Arctic Chiropractic, Sitka with MRI images already in-hand. Arctic Chiropractic, Sitka 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% reduction of back pain in the first 30 days of care before ordering additional imaging or testing or referring for surgical consultation. (6)
CONTACT Arctic Chiropractic, Sitka
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 scheme of treatment for pain relief.
Schedule your Sitka chiropractic appointment with Arctic Chiropractic, Sitka today. Let us explore together the best path to Sitka back pain relief – with or without MRI imaging!
