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 little? 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. The Chiropractic TRUhealthDR carefully weighs the necessity of MRI in the Colorado Springs chiropractic treatment plan of Colorado Springs 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 false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% revealed 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 misinform. 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at The Chiropractic TRUhealthDR, to compare all such findings to patient symptoms. (1,3) Your Colorado Springs 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 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 goal of guidelines is less imaging, fewer false positives.  The Chiropractic TRUhealthDR wants what’s best for our Colorado Springs chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at The Chiropractic TRUhealthDR review all the symptoms, tests and images our Colorado Springs chiropractic back pain patients [[present on|bring with them39] their first Colorado Springs chiropractic visit. So many back pain patients present to The Chiropractic TRUhealthDR with MRI images already with them. The Chiropractic TRUhealthDR will study them but will rely more on clinical exam findings and link them to what the MRI reveals. 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 arranging additional imaging or testing or referring for surgical consultation. (6)

CONTACT The Chiropractic TRUhealthDR

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 Colorado Springs chiropractic appointment with The Chiropractic TRUhealthDR today. Let us discover together the best path to Colorado Springs back pain relief – with or without MRI imaging!