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 percentage of useful, influential MRI studies is so little? False positive MRI results trouble those who get such results. They inspire fear or caution where it’s not always warranted. MRIs like this confuse the proper treatment plan. They spend a lot of money. Manahawkin Chiropractic Center carefully weighs the necessity of MRI in the Manahawkin chiropractic treatment plan of Manahawkin 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 produce false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% uncovered 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 shows that the presence 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 link 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 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 efficacy 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 is 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 come to Manahawkin Chiropractic Center with MRI images already done. Manahawkin Chiropractic Center will look at them but will rely more on clinical exam findings and correlate 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 30 days of care before ordering additional imaging or testing or arranging 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 explains the role of imaging for back pain in the scheme of treatment for pain relief.

Schedule your Manahawkin chiropractic appointment with Manahawkin Chiropractic Center today. Let’s discover together the best path to Manahawkin back pain relief – with or without MRI imaging!