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 questioned. What are MRIs good for when the proportion of constructive, influential MRI studies is so small? False positive MRI results trouble those who get such results. They arouse fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Palmer Chiropractic Center carefully evaluates the necessity of MRI in the Lynchburg chiropractic treatment plan of Lynchburg 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 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 – rises 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 Palmer Chiropractic Center, to correlate all such findings with patient symptoms. (1,3) Your Lynchburg 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 effectiveness 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.  Palmer Chiropractic Center wants what is best for our Lynchburg chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Palmer Chiropractic Center review all the symptoms, tests and images our Lynchburg chiropractic back pain patients [[present on|bring with them39] their first Lynchburg chiropractic visit. So many back pain patients present to Palmer Chiropractic Center with MRI images already done. Palmer 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 additional imaging or testing or referring for surgical consultation. (6)

CONTACT Palmer Chiropractic Center

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 Lynchburg chiropractic appointment with Palmer Chiropractic Center today. Let’s explore together the best path to Lynchburg back pain relief – with or without MRI imaging!