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 proportion of useful, influential MRI studies is so small? False positive MRI results trouble those who receive such results. They arouse fear or caution where it’s not always warranted. MRIs like this blur the proper treatment plan. They spend a lot of money. Manahawkin Chiropractic Center carefully evaluates the need for MRI in the Manahawkin chiropractic treatment plan of Manahawkin 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 trigger misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% revealed 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 misinform. For example, MRI demonstrates that the appearance 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Manahawkin Chiropractic Center, to correlate all such findings with patient symptoms. (1,3) Your Manahawkin 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 sinister). (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 serious cause of back pain. (5) The goal of guidelines is less imaging, fewer false positives. Manahawkin Chiropractic Center wants what’s best for our Manahawkin chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Manahawkin Chiropractic Center study all the symptoms, tests and images our Manahawkin chiropractic back pain patients [[present on|bring with them39] their first Manahawkin chiropractic visit. So many back pain patients present to Manahawkin Chiropractic Center with MRI images already with them. Manahawkin Chiropractic Center 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 work toward 50% reduction of back pain in the first month of care before ordering additional imaging or testing or referring for surgical consultation. (6)
CONTACT Manahawkin 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 program of treatment for pain relief.
Schedule your Manahawkin chiropractic appointment with Manahawkin Chiropractic Center today. Let’s explore together the best path to Manahawkin back pain relief – with or without MRI imaging!
