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 proportion of constructive, influential MRI studies is so small? False positive MRI results distress those who get these results. They inspire fear or caution where it’s not always needed. MRIs like this blur the proper treatment plan. They spend a lot of money. Hollstrom & Associates Inc carefully weighs the need for MRI in the Largo chiropractic treatment plan of Largo back pain relief.
MEDICINE’S VIEW
Interpretations of MRI images by radiologists often differ. 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 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 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Hollstrom & Associates Inc, to compare all such findings to patient symptoms. (1,3) Your Largo 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 (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 reported 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 is best for our Largo chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Hollstrom & Associates Inc study 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 study them but will rely more on clinical exam findings and link them to what the MRI shows. 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 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’s discover together the best path to Largo back pain relief – with or without MRI imaging!
