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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 asked. What are MRIs good for when the proportion of helpful, influential MRI studies is so minor? False positive MRI results trouble those who receive these results. They inspire fear or caution where it’s not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Tarrytown Chiropractic carefully evaluates the need for MRI in the Tarrytown chiropractic treatment plan of Tarrytown 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 trigger misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. 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 shows that the appearance 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 Tarrytown Chiropractic, to correlate all such findings with patient symptoms. (1,3) Your Tarrytown 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 (except when “red flags” are present– issues that suggest something more worrisome). (4) A review of the efficacy 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 goal of guidelines is less imaging, fewer false positives.  Tarrytown Chiropractic wants what’s best for our Tarrytown chiropractic care patients.


Chiropractors like yours at Tarrytown Chiropractic review all the symptoms, tests and images our Tarrytown chiropractic back pain patients [[present on|bring with them39] their first Tarrytown chiropractic visit. So many back pain patients come to Tarrytown Chiropractic with MRI images already in-hand. Tarrytown Chiropractic will look at 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% decrease of back pain in the first month of care before arranging more imaging or testing or arranging 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 Tarrytown chiropractic appointment with Tarrytown Chiropractic today. Let us explore together the best path to Tarrytown back pain relief – with or without MRI imaging!

Tarrytown Chiropractic carefully chooses when and if MRI images are needed to guide the Tarrytown chiropractic treatment plan.  
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