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 asked. What are MRIs good for when the proportion of useful, influential MRI studies is so little? False positive MRI results distress those who get these results. They inspire fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Manchester Chiropractic & Sports Injuries carefully weighs the necessity of MRI in the Manchester chiropractic treatment plan of Manchester 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 trigger misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% found anything suspicious. 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 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 Manchester Chiropractic & Sports Injuries, to link all such findings to patient symptoms. (1,3) Your Manchester chiropractor does this!
CHIROPRACTIC’S VIEW
Choosing Wisely guidelines for American chiropractors suggest30 not repeating spinal imaging and not getting 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 worrying cause of back pain. (5) The objective of guidelines is less imaging, fewer false positives. Manchester Chiropractic & Sports Injuries wants what is best for our Manchester chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Manchester Chiropractic & Sports Injuries review all the symptoms, tests and images our Manchester chiropractic back pain patients [[present on|bring with them39] their first Manchester chiropractic visit. So many back pain patients present to Manchester Chiropractic & Sports Injuries with MRI images already done. Manchester Chiropractic & Sports Injuries will study them but will depend 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% reduction of back pain in the first 30 days of care before ordering additional imaging or testing or arranging surgical consultation. (6)
CONTACT Manchester Chiropractic & Sports Injuries
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 Manchester chiropractic appointment with Manchester Chiropractic & Sports Injuries today. Let’s explore together the best path to Manchester back pain relief – with or without MRI imaging!
