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 trouble those who get these results. They arouse fear or caution where it’s not always warranted. MRIs like this confuse the proper treatment plan. They cost quite a bit. Vancouver Disc Centers carefully weighs the need for MRI in the Vancouver chiropractic treatment plan of Vancouver 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 produce false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. 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 misinform. For example, MRI demonstrates that the presence of disc degeneration in asymptomatic persons – persons with no back pain – grows 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Vancouver Disc Centers, to link all such findings to patient symptoms. (1,3) Your Vancouver 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 (unless there are “red flags” – issues that indicate something more worrisome). (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 worrying cause of back pain. (5) The objective of guidelines is less imaging, fewer false positives.  Vancouver Disc Centers wants what’s best for our Vancouver chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Vancouver Disc Centers review all the symptoms, tests and images our Vancouver chiropractic back pain patients [[present on|bring with them39] their first Vancouver chiropractic visit. So many back pain patients present to Vancouver Disc Centers with MRI images already with them. Vancouver Disc Centers will study them but will rely more on clinical exam findings and link 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 more imaging or testing or arranging surgical consultation. (6)

CONTACT Vancouver Disc Centers

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 Vancouver chiropractic appointment with Vancouver Disc Centers today. Let us discover together the best path to Vancouver back pain relief – with or without MRI imaging!