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 helpful, influential MRI studies is so small? False positive MRI results distress those who receive such results. They arouse fear or caution where it’s not always warranted. MRIs like this confuse the proper treatment plan. They spend a lot of money. 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 false 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 roused 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 correlate 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 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 efficacy 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 goal of guidelines is less imaging, fewer false positives. Gormish Chiropractic & Rehabilitation wants what’s 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 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% reduction of back pain in the first 30 days of care before ordering more imaging or testing or referring for 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 program of treatment for pain relief.
Schedule your Carrolltown chiropractic appointment with Gormish Chiropractic & Rehabilitation today. Let’s explore together the best path to Carrolltown back pain relief – with or without MRI imaging!
