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MRIs - The Positives and the False Positives

May 22, 2018

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 percentage of useful, influential MRI studies is so minor? False positive MRI results upset those who get such results. They inspire fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Cox Chiropractic Medicine Inc carefully evaluates the need for MRI in the Fort Wayne chiropractic treatment plan of Fort Wayne back pain relief.


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 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 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 – 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Cox Chiropractic Medicine Inc, to link all such findings to patient symptoms. (1,3) Your Fort Wayne chiropractor does this!


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 worrisome). (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 serious cause of back pain. (5) The objective of guidelines is less imaging, fewer false positives.  Cox Chiropractic Medicine Inc wants what’s best for our Fort Wayne chiropractic care patients.


Chiropractors like yours at Cox Chiropractic Medicine Inc review all the symptoms, tests and images our Fort Wayne chiropractic back pain patients [[present on|bring with them39] their first Fort Wayne chiropractic visit. So many back pain patients come to Cox Chiropractic Medicine Inc with MRI images already with them. Cox Chiropractic Medicine Inc 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 seek 50% decrease of back pain in the first 30 days of care before ordering more imaging or testing or referring for surgical consultation. (6)

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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 Fort Wayne chiropractic appointment with Cox Chiropractic Medicine Inc today. Let us explore together the best path to Fort Wayne back pain relief – with or without MRI imaging!

Cox Chiropractic Medicine Inc carefully chooses when and if MRI images are needed to guide the Fort Wayne chiropractic treatment plan.