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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 helpful, influential MRI studies is so small? False positive MRI results upset those who get these results. They inspire fear or caution where it’s not always needed. MRIs like this confuse the proper treatment plan. They cost quite a bit. OrthoIllinois Chiropractic carefully evaluates the necessity of MRI in the McHenry chiropractic treatment plan of McHenry back pain relief.


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 cause misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% uncovered anything that needed to be addressed. Of the 36 MRIs that provoked 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at OrthoIllinois Chiropractic, to correlate all such findings with patient symptoms. (1,3) Your McHenry chiropractor does this!


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 effectiveness 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 objective of guidelines is less imaging, fewer false positives.  OrthoIllinois Chiropractic wants what’s best for our McHenry chiropractic care patients.


Chiropractors like yours at OrthoIllinois Chiropractic study all the symptoms, tests and images our McHenry chiropractic back pain patients [[present on|bring with them39] their first McHenry chiropractic visit. So many back pain patients come to OrthoIllinois Chiropractic with MRI images already in-hand. OrthoIllinois Chiropractic 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 seek 50% decrease of back pain in the first 30 days of care before arranging more imaging or testing or referring for surgical consultation. (6)

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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 McHenry chiropractic appointment with OrthoIllinois Chiropractic today. Let us discover together the best path to McHenry back pain relief – with or without MRI imaging!

OrthoIllinois Chiropractic carefully chooses when and if MRI images are needed to guide the McHenry chiropractic treatment plan.  
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"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER page. Content is reviewed by Dr. James M. Cox I."