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 asked. What are MRIs good for when the proportion of useful, influential MRI studies is so minor? False positive MRI results trouble those who receive such results. They inspire fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They cost quite a bit. Layden Chiropractic carefully weighs the need for MRI in the Plainville chiropractic treatment plan of Plainville back pain relief.
MEDICINE’S VIEW
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 trigger 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 mislead. For example, MRI demonstrates that the presence of disc degeneration in asymptomatic persons – persons with no back pain – rises 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Layden Chiropractic, to compare all such findings to patient symptoms. (1,3) Your Plainville 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 (unless there are “red flags” – issues that indicate something more disturbing). (4) A review of the success 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. Layden Chiropractic wants what’s best for our Plainville chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Layden Chiropractic review all the symptoms, tests and images our Plainville chiropractic back pain patients [[present on|bring with them39] their first Plainville chiropractic visit. So many back pain patients present to Layden Chiropractic with MRI images already done. Layden Chiropractic will study them but will depend 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 month of care before arranging more imaging or testing or arranging surgical consultation. (6)
CONTACT Layden Chiropractic
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 Plainville chiropractic appointment with Layden Chiropractic today. Let’s explore together the best path to Plainville back pain relief – with or without MRI imaging!
