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 trouble those who receive 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. Shoreline Medical Services/ Hutter Chiropractic Office carefully weighs the need for MRI in the Groton chiropractic treatment plan of Groton 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 appropriate. Of those, only 13% revealed anything that needed to be addressed. 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 mislead. For example, MRI shows that the appearance 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Shoreline Medical Services/ Hutter Chiropractic Office, to compare all such findings with patient symptoms. (1,3) Your Groton 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 (unless there are “red flags” – 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 reported 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.  Shoreline Medical Services/ Hutter Chiropractic Office wants what’s best for our Groton chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Shoreline Medical Services/ Hutter Chiropractic Office study all the symptoms, tests and images our Groton chiropractic back pain patients [[present on|bring with them39] their first Groton chiropractic visit. So many back pain patients come to Shoreline Medical Services/ Hutter Chiropractic Office with MRI images already in-hand. Shoreline Medical Services/ Hutter Chiropractic Office will look at them but will depend more on clinical exam findings and correlate them to what the MRI shows. 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 ordering additional imaging or testing or referring for surgical consultation. (6)

CONTACT Shoreline Medical Services/ Hutter Chiropractic Office

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 Groton chiropractic appointment with Shoreline Medical Services/ Hutter Chiropractic Office today. Let us discover together the best path to Groton back pain relief – with or without MRI imaging!