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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 examined. What are MRIs good for when the percentage of constructive, influential MRI studies is so little? False positive MRI results upset those who receive these results. They inspire fear or caution where it is not always needed. MRIs like this blur the proper treatment plan. They spend a lot of money. Paulette Hugulet, DC, LLC carefully evaluates the necessity of MRI in the La Grande chiropractic treatment plan of La Grande back pain relief.


Interpretations of MRI images by radiologists often differ.  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 roused 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 appearance of disc degeneration in asymptomatic persons – persons with no back pain – increases 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 Paulette Hugulet, DC, LLC, to correlate all such findings with patient symptoms. (1,3) Your La Grande chiropractor does this!


Choosing Wisely guidelines for American chiropractors recommend not repeating spinal imaging and not getting spinal imaging for patients with acute low back pain in the first 6 weeks of back pain (unless there are “red flags” – 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 serious cause of back pain. (5) The goal of guidelines is less imaging, fewer false positives.  Paulette Hugulet, DC, LLC wants what is best for our La Grande chiropractic care patients.


Chiropractors like yours at Paulette Hugulet, DC, LLC study all the symptoms, tests and images our La Grande chiropractic back pain patients [[present on|bring with them39] their first La Grande chiropractic visit. So many back pain patients present to Paulette Hugulet, DC, LLC with MRI images already done. Paulette Hugulet, DC, LLC will look at them but will depend 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 referring for surgical consultation. (6)

CONTACT Paulette Hugulet, DC, LLC

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 La Grande chiropractic appointment with Paulette Hugulet, DC, LLC today. Let us discover together the best path to La Grande back pain relief – with or without MRI imaging!

Paulette Hugulet, DC, LLC carefully chooses when and if MRI images are needed to guide the La Grande 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."