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 questioned. What are MRIs good for when the proportion of helpful, influential MRI studies is so small? False positive MRI results distress those who get these results. They inspire fear or caution where it is not always warranted. MRIs like this blur the proper treatment plan. They cost quite a bit. Spine & Sports Rehab Center carefully evaluates the need for MRI in the Baton Rouge chiropractic treatment plan of Baton Rouge 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 cause false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% revealed 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 Spine & Sports Rehab Center, to correlate all such findings to patient symptoms. (1,3) Your Baton Rouge 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 (except when “red flags” are present– issues that indicate something more sinister). (4) A review of the success of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms reported that there is very low risk of missing a serious cause of back pain. (5) The goal of guidelines is less imaging, fewer false positives.  Spine & Sports Rehab Center wants what is best for our Baton Rouge chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Spine & Sports Rehab Center review all the symptoms, tests and images our Baton Rouge chiropractic back pain patients [[present on|bring with them39] their first Baton Rouge chiropractic visit. So many back pain patients present to Spine & Sports Rehab Center with MRI images already with them. Spine & Sports Rehab Center will study them but will rely 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 seek 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 Spine & Sports Rehab Center

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 Baton Rouge chiropractic appointment with Spine & Sports Rehab Center today. Let us discover together the best path to Baton Rouge back pain relief – with or without MRI imaging!