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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 asked. What are MRIs good for when the proportion of constructive, influential MRI studies is so little? False positive MRI results upset those who get such results. They arouse fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Moriarty Chiropractic carefully weighs the necessity of MRI in the Nashua chiropractic treatment plan of Nashua 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 appropriate. Of those, only 13% uncovered 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 misinform. For example, MRI demonstrates 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Moriarty Chiropractic, to link all such findings to patient symptoms. (1,3) Your Nashua chiropractor does this!


Choosing Wisely guidelines for American chiropractors suggest30 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 indicate something more sinister). (4) A review of the effectiveness 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.  Moriarty Chiropractic wants what’s best for our Nashua chiropractic care patients.


Chiropractors like yours at Moriarty Chiropractic review all the symptoms, tests and images our Nashua chiropractic back pain patients [[present on|bring with them39] their first Nashua chiropractic visit. So many back pain patients present to Moriarty Chiropractic with MRI images already in-hand. Moriarty Chiropractic will study them but will rely more on clinical exam findings and link 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 ordering 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 explains the role of imaging for back pain in the scheme of treatment for pain relief.

Schedule your Nashua chiropractic appointment with Moriarty Chiropractic today. Let’s explore together the best path to Nashua back pain relief – with or without MRI imaging!

Moriarty Chiropractic carefully decides when and if MRI images are needed to guide the Nashua chiropractic treatment plan.