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.
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 suspicious. 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 demonstrates 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!
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 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. 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 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 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