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 asked. What are MRIs good for when the proportion of helpful, influential MRI studies is so small? False positive MRI results upset those who get such results. They arouse fear or caution where it’s not always warranted. MRIs like this blur the proper treatment plan. They spend a lot of money. Chiropractic Spine Sports And Rehabilitation carefully evaluates the need for MRI in the Tonawanda chiropractic treatment plan of Tonawanda 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 misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% uncovered 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 mislead. For example, MRI shows 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 Chiropractic Spine Sports And Rehabilitation, to compare all such findings with patient symptoms. (1,3) Your Tonawanda 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 (except when “red flags” are present– issues that suggest something more disturbing). (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 goal of guidelines is less imaging, fewer false positives. Chiropractic Spine Sports And Rehabilitation wants what’s best for our Tonawanda chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Chiropractic Spine Sports And Rehabilitation study all the symptoms, tests and images our Tonawanda chiropractic back pain patients [[present on|bring with them39] their first Tonawanda chiropractic visit. So many back pain patients come to Chiropractic Spine Sports And Rehabilitation with MRI images already done. Chiropractic Spine Sports And Rehabilitation 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 seek 50% reduction of back pain in the first 30 days of care before ordering more imaging or testing or arranging surgical consultation. (6)
CONTACT Chiropractic Spine Sports And Rehabilitation
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 Tonawanda chiropractic appointment with Chiropractic Spine Sports And Rehabilitation today. Let us explore together the best path to Tonawanda back pain relief – with or without MRI imaging!
