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 examined. What are MRIs good for when the proportion of constructive, influential MRI studies is so small? False positive MRI results trouble those who get these results. They inspire fear or caution where it is not always warranted. MRIs like this confuse the proper treatment plan. They cost quite a bit. Poulin Chiropractic of Herndon and Ashburn carefully weighs the need for MRI in the Ashburn chiropractic treatment plan of Ashburn 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 appropriate. 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 appearance of disc degeneration in asymptomatic persons – persons with no back pain – rises 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 Poulin Chiropractic of Herndon and Ashburn, to correlate all such findings with patient symptoms. (1,3) Your Ashburn 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 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 worrying cause of back pain. (5) The goal of guidelines is less imaging, fewer false positives.  Poulin Chiropractic of Herndon and Ashburn wants what is best for our Ashburn chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Poulin Chiropractic of Herndon and Ashburn study all the symptoms, tests and images our Ashburn chiropractic back pain patients [[present on|bring with them39] their first Ashburn chiropractic visit. So many back pain patients come to Poulin Chiropractic of Herndon and Ashburn with MRI images already with them. Poulin Chiropractic of Herndon and Ashburn 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 arranging more imaging or testing or referring for surgical consultation. (6)

CONTACT Poulin Chiropractic of Herndon and Ashburn

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 Ashburn chiropractic appointment with Poulin Chiropractic of Herndon and Ashburn today. Let us discover together the best path to Ashburn back pain relief – with or without MRI imaging!