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 constructive, influential MRI studies is so minor? False positive MRI results distress those who receive these results. They inspire fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Rethwill Chiropractic Clinic carefully evaluates the necessity of MRI in the Eugene chiropractic treatment plan of Eugene 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 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 that needed to be addressed. 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 mislead. For example, MRI shows that the appearance 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Rethwill Chiropractic Clinic, to correlate all such findings with patient symptoms. (1,3) Your Eugene chiropractor does this!

CHIROPRACTIC’S VIEW

Choosing Wisely guidelines for American chiropractors recommend not repeating spinal imaging and not getting spinal imaging for patients with acute low back pain in the first 6 weeks of back pain (unless there are “red flags” – issues that suggest something more sinister). (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 serious cause of back pain. (5) The goal of guidelines is less imaging, fewer false positives.  Rethwill Chiropractic Clinic wants what is best for our Eugene chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Rethwill Chiropractic Clinic review all the symptoms, tests and images our Eugene chiropractic back pain patients [[present on|bring with them39] their first Eugene chiropractic visit. So many back pain patients present to Rethwill Chiropractic Clinic with MRI images already with them. Rethwill Chiropractic Clinic 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% decrease of back pain in the first 30 days of care before ordering additional imaging or testing or arranging surgical consultation. (6)

CONTACT Rethwill Chiropractic 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 Eugene chiropractic appointment with Rethwill Chiropractic Clinic today. Let’s explore together the best path to Eugene back pain relief – with or without MRI imaging!