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 useful, influential MRI studies is so small? False positive MRI results trouble those who get such results. They inspire fear or caution where it’s not always needed. MRIs like this confuse the proper treatment plan. They cost quite a bit. Vancouver Spine Care Centre carefully weighs the need for MRI in the Vancouver chiropractic treatment plan of Vancouver 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 produce false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% uncovered anything suspicious. Of the 36 MRIs that roused 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 – 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Vancouver Spine Care Centre, to compare 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 getting 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 suggest something more worrisome). (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 serious cause of back pain. (5) The objective of guidelines is less imaging, fewer false positives.  Vancouver Spine Care Centre wants what is best for our Vancouver chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Vancouver Spine Care Centre 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 come to Vancouver Spine Care Centre with MRI images already in-hand. Vancouver Spine Care Centre 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% reduction of back pain in the first 30 days of care before arranging additional imaging or testing or arranging surgical consultation. (6)

CONTACT Vancouver Spine Care Centre

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 program of treatment for pain relief.

Schedule your Vancouver chiropractic appointment with Vancouver Spine Care Centre today. Let us discover together the best path to Vancouver back pain relief – with or without MRI imaging!