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 questioned. What are MRIs good for when the proportion of useful, influential MRI studies is so small? False positive MRI results upset those who get such results. They inspire fear or caution where it is not always needed. MRIs like this blur the proper treatment plan. They cost quite a bit. Novelli Wellness Center carefully evaluates the necessity of MRI in the Orchard Park, NY chiropractic treatment plan of Orchard Park, NY 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 produce false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% revealed anything that needed to be addressed. 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Novelli Wellness Center, to correlate all such findings with patient symptoms. (1,3) Your Orchard Park, NY 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 success 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 goal of guidelines is less imaging, fewer false positives.  Novelli Wellness Center wants what is best for our Orchard Park, NY chiropractic care patients.


Chiropractors like yours at Novelli Wellness Center review all the symptoms, tests and images our Orchard Park, NY chiropractic back pain patients [[present on|bring with them39] their first Orchard Park, NY chiropractic visit. So many back pain patients present to Novelli Wellness Center with MRI images already in-hand. Novelli Wellness Center will look at 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% reduction of back pain in the first month of care before ordering more imaging or testing or referring for surgical consultation. (6)

CONTACT Novelli Wellness Center

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 Orchard Park, NY chiropractic appointment with Novelli Wellness Center today. Let us discover together the best path to Orchard Park, NY back pain relief – with or without MRI imaging!

Novelli Wellness Center carefully chooses when and if MRI images are needed to guide the Orchard Park, NY chiropractic treatment plan.  
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"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER page. Content is reviewed by Dr. James M. Cox I."