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.
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!
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 serious 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