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 questioned. What are MRIs good for when the percentage of helpful, influential MRI studies is so little? False positive MRI results trouble those who receive these results. They inspire fear or caution where it’s not always needed. MRIs like this blur the proper treatment plan. They cost quite a bit. Poulin Chiropractic of Herndon and Ashburn carefully evaluates the need for MRI in the Ashburn and Herndon chiropractic treatment plan of Ashburn and Herndon 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 produce misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% uncovered anything that needed to be addressed. 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 shows 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Poulin Chiropractic of Herndon and Ashburn, to compare all such findings with patient symptoms. (1,3) Your Ashburn and Herndon 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 (except when “red flags” are present– issues that indicate something more sinister). (4) A review of the success 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 purpose of guidelines is less imaging, fewer false positives.  Poulin Chiropractic of Herndon and Ashburn wants what’s best for our Ashburn and Herndon 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 and Herndon chiropractic back pain patients [[present on|bring with them39] their first Ashburn and Herndon chiropractic visit. So many back pain patients present 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 depend 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% decrease of back pain in the first 30 days of care before ordering additional imaging or testing or arranging 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 describes imaging for back pain in the program of treatment for pain relief.

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