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 examined. What are MRIs good for when the proportion of useful, influential MRI studies is so minor? False positive MRI results trouble those who get such results. They inspire fear or caution where it’s not always warranted. MRIs like this blur the proper treatment plan. They cost quite a bit. Aurora Chiropractic Center carefully evaluates the necessity of MRI in the Juneau chiropractic treatment plan of Juneau 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 trigger 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 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 shows that the presence 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 Aurora Chiropractic Center, to correlate all such findings to patient symptoms. (1,3) Your Juneau 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 (except when “red flags” are present– issues that indicate something more disturbing). (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. Aurora Chiropractic Center wants what is best for our Juneau chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Aurora Chiropractic Center review all the symptoms, tests and images our Juneau chiropractic back pain patients [[present on|bring with them39] their first Juneau chiropractic visit. So many back pain patients present to Aurora Chiropractic Center with MRI images already done. Aurora Chiropractic Center will study 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 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 Aurora 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 Juneau chiropractic appointment with Aurora Chiropractic Center today. Let us explore together the best path to Juneau back pain relief – with or without MRI imaging!
