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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 questioned. What are MRIs good for when the percentage of useful, influential MRI studies is so small? False positive MRI results upset those who get these results. They inspire fear or caution where it is not always needed. MRIs like this blur the proper treatment plan. They cost quite a bit. Gormish Chiropractic & Rehabilitation carefully evaluates the necessity of MRI in the Carrolltown chiropractic treatment plan of Carrolltown 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 produce misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% revealed anything suspicious. Of the 36 MRIs that caused 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 presence 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Gormish Chiropractic & Rehabilitation, to compare all such findings with patient symptoms. (1,3) Your Carrolltown chiropractor does this!

CHIROPRACTIC’S VIEW

Choosing Wisely guidelines for American chiropractors recommend 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 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 worrying cause of back pain. (5) The objective of guidelines is less imaging, fewer false positives.  Gormish Chiropractic & Rehabilitation wants what is best for our Carrolltown chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Gormish Chiropractic & Rehabilitation review all the symptoms, tests and images our Carrolltown chiropractic back pain patients [[present on|bring with them39] their first Carrolltown chiropractic visit. So many back pain patients present to Gormish Chiropractic & Rehabilitation with MRI images already done. Gormish Chiropractic & Rehabilitation 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 arranging surgical consultation. (6)

CONTACT Gormish Chiropractic & Rehabilitation

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 Carrolltown chiropractic appointment with Gormish Chiropractic & Rehabilitation today. Let us discover together the best path to Carrolltown back pain relief – with or without MRI imaging!

 
Gormish Chiropractic & Rehabilitation carefully decides when and if MRI images are needed to guide the Carrolltown chiropractic treatment plan.  
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