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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 percentage of useful, influential MRI studies is so small? False positive MRI results trouble those who get these results. They arouse fear or caution where it’s not always needed. MRIs like this confuse the proper treatment plan. They cost quite a bit. Watertown Wellness Center carefully evaluates the necessity of MRI in the Watertown chiropractic treatment plan of Watertown 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% found 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 demonstrates 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Watertown Wellness Center, to compare all such findings to patient symptoms. (1,3) Your Watertown 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.  Watertown Wellness Center wants what is best for our Watertown chiropractic care patients.

COX® TECHNIC’S VIEW

Chiropractors like yours at Watertown Wellness Center review all the symptoms, tests and images our Watertown chiropractic back pain patients [[present on|bring with them39] their first Watertown chiropractic visit. So many back pain patients present to Watertown Wellness Center with MRI images already with them. Watertown Wellness Center will study them but will depend 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 ordering additional imaging or testing or arranging surgical consultation. (6)

CONTACT Watertown Wellness Center

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 Watertown chiropractic appointment with Watertown Wellness Center today. Let us discover together the best path to Watertown back pain relief – with or without MRI imaging!

 
Watertown Wellness Center carefully chooses when and if MRI images are needed to guide the Watertown chiropractic treatment plan.  
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