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 helpful, influential MRI studies is so small? False positive MRI results trouble those who receive such results. They inspire fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Amelia Chiropractic Clinic carefully weighs the need for MRI in the Fernandina Beach chiropractic treatment plan of Fernandina Beach back pain relief.

MEDICINE’S VIEW

MRI interpretations by radiologists often vary.  The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may cause 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 that needed to be addressed. Of the 36 MRIs that caused 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 – grows 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 Amelia Chiropractic Clinic, to correlate all such findings with patient symptoms. (1,3) Your Fernandina Beach 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 worrisome). (4) A review of the success 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.  Amelia Chiropractic Clinic wants what’s best for our Fernandina Beach chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Amelia Chiropractic Clinic review all the symptoms, tests and images our Fernandina Beach chiropractic back pain patients [[present on|bring with them39] their first Fernandina Beach chiropractic visit. So many back pain patients present to Amelia Chiropractic Clinic with MRI images already with them. Amelia Chiropractic Clinic will look at them but will depend 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% decrease of back pain in the first month of care before arranging additional imaging or testing or arranging surgical consultation. (6)

CONTACT Amelia Chiropractic Clinic

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 scheme of treatment for pain relief.

Schedule your Fernandina Beach chiropractic appointment with Amelia Chiropractic Clinic today. Let us explore together the best path to Fernandina Beach back pain relief – with or without MRI imaging!