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 asked. What are MRIs good for when the percentage of useful, influential MRI studies is so little? False positive MRI results distress those who receive such results. They arouse fear or caution where it’s not always needed. MRIs like this blur the proper treatment plan. They cost quite a bit. Minster Chiropractic Center carefully evaluates the need for MRI in the Minster chiropractic treatment plan of Minster 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 produce 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 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 shows that the presence of disc degeneration in asymptomatic persons – persons with no back pain – increases 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 Minster Chiropractic Center, to correlate all such findings with patient symptoms. (1,3) Your Minster 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 indicate something more disturbing). (4) A review of the efficacy 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. Minster Chiropractic Center wants what’s best for our Minster chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Minster Chiropractic Center study all the symptoms, tests and images our Minster chiropractic back pain patients [[present on|bring with them39] their first Minster chiropractic visit. So many back pain patients come to Minster Chiropractic Center with MRI images already with them. Minster Chiropractic Center will look at 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 Minster Chiropractic Center
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 Minster chiropractic appointment with Minster Chiropractic Center today. Let us explore together the best path to Minster back pain relief – with or without MRI imaging!
