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 percentage of useful, influential MRI studies is so little? False positive MRI results distress those who get these results. They arouse fear or caution where it’s not always needed. MRIs like this confuse the proper treatment plan. They cost quite a bit. Old Mill Chiropractic carefully evaluates the need for MRI in the St Peters chiropractic treatment plan of St Peters back pain relief.
MEDICINE’S VIEW
Interpretations of MRI images 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 appropriate. Of those, only 13% uncovered anything that needed to be addressed. Of the 36 MRIs that provoked 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Old Mill Chiropractic, to compare all such findings to patient symptoms. (1,3) Your St Peters 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 worrisome). (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 worrying cause of back pain. (5) The purpose of guidelines is less imaging, fewer false positives. Old Mill Chiropractic wants what’s best for our St Peters chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Old Mill Chiropractic study all the symptoms, tests and images our St Peters chiropractic back pain patients [[present on|bring with them39] their first St Peters chiropractic visit. So many back pain patients present to Old Mill Chiropractic with MRI images already with them. Old Mill Chiropractic will study 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 month of care before ordering additional imaging or testing or referring for surgical consultation. (6)
CONTACT Old Mill Chiropractic
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 program of treatment for pain relief.
Schedule your St Peters chiropractic appointment with Old Mill Chiropractic today. Let’s discover together the best path to St Peters back pain relief – with or without MRI imaging!
