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 useful, influential MRI studies is so small? False positive MRI results trouble those who receive these results. They arouse fear or caution where it’s not always warranted. MRIs like this confuse the proper treatment plan. They cost quite a bit. Aaron Chiropractic Clinic carefully weighs the necessity of MRI in the Fort Wayne chiropractic treatment plan of Fort Wayne 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 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 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 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 Aaron Chiropractic Clinic, to compare all such findings with patient symptoms. (1,3) Your Fort Wayne 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 suggest something more sinister). (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 objective of guidelines is less imaging, fewer false positives.  Aaron Chiropractic Clinic wants what’s best for our Fort Wayne chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Aaron Chiropractic Clinic study all the symptoms, tests and images our Fort Wayne chiropractic back pain patients [[present on|bring with them39] their first Fort Wayne chiropractic visit. So many back pain patients present to Aaron Chiropractic Clinic with MRI images already in-hand. Aaron 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 seek 50% reduction of back pain in the first 30 days of care before ordering more imaging or testing or referring for surgical consultation. (6)

CONTACT Aaron 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 program of treatment for pain relief.

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