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 asked. What are MRIs good for when the proportion of constructive, influential MRI studies is so little? False positive MRI results distress those who get such results. They arouse fear or caution where it’s not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Satterwhite Chiropractic carefully weighs the necessity of MRI in the Oxford chiropractic treatment plan of Oxford 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 trigger false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% uncovered anything that needed to be addressed. 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 – 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Satterwhite Chiropractic, to compare all such findings to patient symptoms. (1,3) Your Oxford 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 effectiveness 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.  Satterwhite Chiropractic wants what’s best for our Oxford chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Satterwhite Chiropractic review all the symptoms, tests and images our Oxford chiropractic back pain patients [[present on|bring with them39] their first Oxford chiropractic visit. So many back pain patients present to Satterwhite Chiropractic with MRI images already done. Satterwhite Chiropractic will study them but will depend 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% decrease of back pain in the first month of care before ordering additional imaging or testing or referring for surgical consultation. (6)

CONTACT Satterwhite Chiropractic

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 scheme of treatment for pain relief.

Schedule your Oxford chiropractic appointment with Satterwhite Chiropractic today. Let’s explore together the best path to Oxford back pain relief – with or without MRI imaging!

 
Satterwhite Chiropractic carefully decides when and if MRI images are needed to guide the Oxford chiropractic treatment plan.  
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