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 percentage of helpful, influential MRI studies is so small? False positive MRI results trouble those who get such results. They arouse fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They cost quite a bit. Aaron Chiropractic Clinic carefully weighs the need for MRI in the Fort Wayne chiropractic treatment plan of Fort Wayne 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 cause false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% found 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 shows 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Aaron Chiropractic Clinic, to compare all such findings to patient symptoms. (1,3) Your Fort Wayne 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 disturbing). (4) A review of the effectiveness of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms stated that there is very low risk of missing a serious cause of back pain. (5) The goal 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 review 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 come to Aaron Chiropractic Clinic with MRI images already in-hand. Aaron Chiropractic Clinic will study them but will depend more on clinical exam findings and correlate them to what the MRI reveals. 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 arranging additional 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 scheme of treatment for pain relief.
Schedule your Fort Wayne chiropractic appointment with Aaron Chiropractic Clinic today. Let us discover together the best path to Fort Wayne back pain relief – with or without MRI imaging!
