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 examined. What are MRIs good for when the percentage of helpful, influential MRI studies is so minor? False positive MRI results trouble those who receive these results. They inspire fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Rosenberg Wellness Center carefully evaluates the necessity of MRI in the New York City chiropractic treatment plan of New York City 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 produce 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 that needed to be addressed. 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 shows that the presence 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Rosenberg Wellness Center, to link all such findings to patient symptoms. (1,3) Your New York City 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 suggest something more disturbing). (4) A review of the efficacy 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. Rosenberg Wellness Center wants what’s best for our New York City chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Rosenberg Wellness Center study all the symptoms, tests and images our New York City chiropractic back pain patients [[present on|bring with them39] their first New York City chiropractic visit. So many back pain patients come to Rosenberg Wellness Center with MRI images already with them. Rosenberg Wellness Center will study them but will rely more on clinical exam findings and correlate 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 month of care before arranging more imaging or testing or arranging surgical consultation. (6)
CONTACT Rosenberg Wellness Center
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 New York City chiropractic appointment with Rosenberg Wellness Center today. Let’s discover together the best path to New York City back pain relief – with or without MRI imaging!
