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 asked. What are MRIs good for when the proportion of constructive, influential MRI studies is so little? False positive MRI results upset those who receive these results. They arouse fear or caution where it’s not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Young Chiropractic carefully evaluates the need for MRI in the Easley chiropractic treatment plan of Easley back pain relief.


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 false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% uncovered anything that needed to be addressed. 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 appearance 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Young Chiropractic, to link all such findings with patient symptoms. (1,3) Your Easley 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 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 worrying cause of back pain. (5) The purpose of guidelines is less imaging, fewer false positives.  Young Chiropractic wants what’s best for our Easley chiropractic care patients.


Chiropractors like yours at Young Chiropractic review all the symptoms, tests and images our Easley chiropractic back pain patients [[present on|bring with them39] their first Easley chiropractic visit. So many back pain patients present to Young Chiropractic with MRI images already in-hand. Young Chiropractic will look at them but will rely 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 arranging additional 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 Easley chiropractic appointment with Young Chiropractic today. Let us discover together the best path to Easley back pain relief – with or without MRI imaging!

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