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 percentage of constructive, influential MRI studies is so small? False positive MRI results upset those who receive these results. They arouse fear or caution where it’s not always needed. MRIs like this blur the proper treatment plan. They cost quite a bit. Executive Chiropractic of Iowa carefully weighs the need for MRI in the West Des Moines chiropractic treatment plan of West Des Moines back pain relief.

MEDICINE’S VIEW

MRI interpretations 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 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 misinform. 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 Executive Chiropractic of Iowa, to correlate all such findings to patient symptoms. (1,3) Your West Des Moines chiropractor does this!

CHIROPRACTIC’S VIEW

Choosing Wisely guidelines for American chiropractors suggest30 not repeating spinal imaging and not getting 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 effectiveness 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 objective of guidelines is less imaging, fewer false positives.  Executive Chiropractic of Iowa wants what’s best for our West Des Moines chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Executive Chiropractic of Iowa review all the symptoms, tests and images our West Des Moines chiropractic back pain patients [[present on|bring with them39] their first West Des Moines chiropractic visit. So many back pain patients come to Executive Chiropractic of Iowa with MRI images already with them. Executive Chiropractic of Iowa will study them but will rely more on clinical exam findings and link them to what the MRI shows. A rule of thumb with the Cox Technic System of Back Pain Relief is to seek 50% decrease of back pain in the first month of care before ordering additional imaging or testing or referring for surgical consultation. (6)

CONTACT Executive Chiropractic of Iowa

Listen to this PODCAST with Dr. Dan Clark on the Back Doctor’s Podcast with Dr. Michael Johnson as he describes imaging for back pain in the scheme of treatment for pain relief.

Schedule your West Des Moines chiropractic appointment with Executive Chiropractic of Iowa today. Let’s explore together the best path to West Des Moines back pain relief – with or without MRI imaging!