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 upset those who get these results. They arouse fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Dr. Paulette Hugulet, DC, LLC carefully evaluates the necessity of MRI in the La Grande chiropractic treatment plan of La Grande 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 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 suspicious. Of the 36 MRIs that caused 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 demonstrates that the presence 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Dr. Paulette Hugulet, DC, LLC, to link all such findings with patient symptoms. (1,3) Your La Grande chiropractor does this!
CHIROPRACTIC’S VIEW
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 indicate something more disturbing). (4) A review of the efficacy 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. Dr. Paulette Hugulet, DC, LLC wants what’s best for our La Grande chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Dr. Paulette Hugulet, DC, LLC study all the symptoms, tests and images our La Grande chiropractic back pain patients [[present on|bring with them39] their first La Grande chiropractic visit. So many back pain patients present to Dr. Paulette Hugulet, DC, LLC with MRI images already in-hand. Dr. Paulette Hugulet, DC, LLC will look at them but will depend 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 month of care before arranging additional imaging or testing or arranging surgical consultation. (6)
CONTACT Dr. Paulette Hugulet, DC, LLC
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 La Grande chiropractic appointment with Dr. Paulette Hugulet, DC, LLC today. Let’s discover together the best path to La Grande back pain relief – with or without MRI imaging!
