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MRIs - The Positives and the False Positives

May 22, 2018

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 small? False positive MRI results upset those who receive such 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. Lombardy Chiropractic Clinic carefully weighs the necessity of MRI in the Augusta chiropractic treatment plan of Augusta back pain relief.


MRI interpretations by radiologists often vary.  The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may cause false 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 raised 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 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Lombardy Chiropractic Clinic, to compare all such findings with patient symptoms. (1,3) Your Augusta chiropractor does this!


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 (unless there are “red flags” – issues that indicate something more disturbing). (4) A review of the success 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 purpose of guidelines is less imaging, fewer false positives.  Lombardy Chiropractic Clinic wants what is best for our Augusta chiropractic care patients.


Chiropractors like yours at Lombardy Chiropractic Clinic review all the symptoms, tests and images our Augusta chiropractic back pain patients [[present on|bring with them39] their first Augusta chiropractic visit. So many back pain patients come to Lombardy Chiropractic Clinic with MRI images already in-hand. Lombardy Chiropractic Clinic will look at them but will depend more on clinical exam findings and correlate 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 month 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 explains the role of imaging for back pain in the scheme of treatment for pain relief.

Schedule your Augusta chiropractic appointment with Lombardy Chiropractic Clinic today. Let us discover together the best path to Augusta back pain relief – with or without MRI imaging!

Lombardy Chiropractic Clinic carefully decides when and if MRI images are needed to guide the Augusta chiropractic treatment plan.