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 useful, influential MRI studies is so little? False positive MRI results distress those who get such results. They arouse fear or caution where it’s not always warranted. MRIs like this confuse the proper treatment plan. They spend a lot of money. OrthoIllinois Chiropractic carefully weighs the necessity of MRI in the McHenry chiropractic treatment plan of McHenry back pain relief.
MEDICINE’S VIEW
MRI interpretations by radiologists often differ. 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% revealed 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 mislead. 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 OrthoIllinois Chiropractic, to compare all such findings to patient symptoms. (1,3) Your McHenry 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 (unless there are “red flags” – 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 purpose of guidelines is less imaging, fewer false positives. OrthoIllinois Chiropractic wants what’s best for our McHenry chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at OrthoIllinois Chiropractic review 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 present to OrthoIllinois Chiropractic with MRI images already done. OrthoIllinois Chiropractic will study 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 30 days of care before ordering more imaging or testing or arranging surgical consultation. (6)
CONTACT OrthoIllinois Chiropractic
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 McHenry chiropractic appointment with OrthoIllinois Chiropractic today. Let us discover together the best path to McHenry back pain relief – with or without MRI imaging!
