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 asked. What are MRIs good for when the percentage of helpful, influential MRI studies is so minor? False positive MRI results trouble 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. Spinal Care Clinic carefully weighs the need for MRI in the Burlington and Hamilton chiropractic treatment plan of Burlington and Hamilton 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 trigger misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% found 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 presence 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 Spinal Care Clinic, to link all such findings with patient symptoms. (1,3) Your Burlington and Hamilton 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 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 purpose of guidelines is less imaging, fewer false positives.  Spinal Care Clinic wants what’s best for our Burlington and Hamilton chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Spinal Care Clinic review all the symptoms, tests and images our Burlington and Hamilton chiropractic back pain patients [[present on|bring with them39] their first Burlington and Hamilton chiropractic visit. So many back pain patients present to Spinal Care Clinic with MRI images already done. Spinal Care Clinic 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 seek 50% reduction of back pain in the first 30 days of care before arranging more imaging or testing or arranging surgical consultation. (6)

CONTACT Spinal Care 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 Burlington and Hamilton chiropractic appointment with Spinal Care Clinic today. Let us explore together the best path to Burlington and Hamilton back pain relief – with or without MRI imaging!