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 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. Dr. Hoang's Chiropractic Clinic carefully evaluates the necessity of MRI in the Montreal chiropractic treatment plan of Montreal 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 misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% revealed 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 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Dr. Hoang's Chiropractic Clinic, to compare all such findings to patient symptoms. (1,3) Your Montreal 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 (unless there are “red flags” – issues that indicate something more disturbing). (4) A review of the effectiveness 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 goal of guidelines is less imaging, fewer false positives. Dr. Hoang's Chiropractic Clinic wants what is best for our Montreal chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Dr. Hoang's Chiropractic Clinic review all the symptoms, tests and images our Montreal chiropractic back pain patients [[present on|bring with them39] their first Montreal chiropractic visit. So many back pain patients present to Dr. Hoang's Chiropractic Clinic with MRI images already done. Dr. Hoang's Chiropractic Clinic will study them but will rely more on clinical exam findings and link 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 30 days of care before arranging additional imaging or testing or arranging surgical consultation. (6)
CONTACT Dr. Hoang's Chiropractic Clinic
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 Montreal chiropractic appointment with Dr. Hoang's Chiropractic Clinic today. Let us discover together the best path to Montreal back pain relief – with or without MRI imaging!
