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 useful, influential MRI studies is so small? False positive MRI results distress those who receive such results. They inspire fear or caution where it is not always needed. MRIs like this blur the proper treatment plan. They cost quite a bit. Malverne Health & Wellness carefully evaluates the need for MRI in the Malverne chiropractic treatment plan of Malverne back pain relief.

MEDICINE’S VIEW

MRI interpretations by radiologists often differ.  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% revealed anything suspicious. Of the 36 MRIs that provoked 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 – 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Malverne Health & Wellness, to link all such findings with patient symptoms. (1,3) Your Malverne chiropractor does this!

CHIROPRACTIC’S VIEW

Choosing Wisely guidelines for American chiropractors recommend 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 suggest something more worrisome). (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 purpose of guidelines is less imaging, fewer false positives.  Malverne Health & Wellness wants what is best for our Malverne chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Malverne Health & Wellness review all the symptoms, tests and images our Malverne chiropractic back pain patients [[present on|bring with them39] their first Malverne chiropractic visit. So many back pain patients present to Malverne Health & Wellness with MRI images already with them. Malverne Health & Wellness will look at 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 additional imaging or testing or referring for surgical consultation. (6)

CONTACT Malverne Health & Wellness

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 program of treatment for pain relief.

Schedule your Malverne chiropractic appointment with Malverne Health & Wellness today. Let us discover together the best path to Malverne back pain relief – with or without MRI imaging!