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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 percentage of constructive, influential MRI studies is so minor? False positive MRI results distress those who get such results. They inspire fear or caution where it’s not always warranted. MRIs like this confuse the proper treatment plan. They spend a lot of money. Hollstrom & Associates Inc carefully weighs the necessity of MRI in the Largo chiropractic treatment plan of Largo back pain relief.


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 trigger false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% found 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 mislead. For example, MRI shows that the appearance 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 Hollstrom & Associates Inc, to correlate all such findings with patient symptoms. (1,3) Your Largo chiropractor does this!


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 suggest something more disturbing). (4) A review of the success of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms stated that there is very low risk of missing a worrying cause of back pain. (5) The objective of guidelines is less imaging, fewer false positives.  Hollstrom & Associates Inc wants what’s best for our Largo chiropractic care patients.


Chiropractors like yours at Hollstrom & Associates Inc review all the symptoms, tests and images our Largo chiropractic back pain patients [[present on|bring with them39] their first Largo chiropractic visit. So many back pain patients come to Hollstrom & Associates Inc with MRI images already in-hand. Hollstrom & Associates Inc 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 work toward 50% decrease of back pain in the first month of care before ordering more imaging or testing or arranging surgical consultation. (6)

CONTACT Hollstrom & Associates Inc

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 Largo chiropractic appointment with Hollstrom & Associates Inc today. Let us discover together the best path to Largo back pain relief – with or without MRI imaging!

Hollstrom & Associates Inc carefully chooses when and if MRI images are needed to guide the Largo chiropractic treatment plan.  
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"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER page. Content is reviewed by Dr. James M. Cox I."