MRIs - The Positives and the False Positives

Tests – what are they good for?

When it comes to back pain tests, of MRIs that question must be questioned. What are MRIs good for when the percentage of useful, influential MRI studies is so small? False positive MRI results distress those who receive these results. They inspire fear or caution where it’s not always needed. MRIs like this blur the proper treatment plan. They spend a lot of money. Pflugerville Wellness Center carefully weighs the necessity of MRI in the Pflugerville chiropractic treatment plan of Pflugerville 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 misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% uncovered anything suspicious. Of the 36 MRIs that provoked 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 – 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Pflugerville Wellness Center, to compare all such findings to patient symptoms. (1,3) Your Pflugerville 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 efficacy 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 purpose of guidelines is less imaging, fewer false positives.  Pflugerville Wellness Center wants what’s best for our Pflugerville chiropractic care patients.


Chiropractors like yours at Pflugerville Wellness Center review all the symptoms, tests and images our Pflugerville chiropractic back pain patients [[present on|bring with them39] their first Pflugerville chiropractic visit. So many back pain patients come to Pflugerville Wellness Center with MRI images already done. Pflugerville Wellness Center will study 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 seek 50% decrease of back pain in the first 30 days of care before ordering more imaging or testing or arranging surgical consultation. (6)

CONTACT Pflugerville 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 Pflugerville chiropractic appointment with Pflugerville Wellness Center today. Let us discover together the best path to Pflugerville back pain relief – with or without MRI imaging!

Pflugerville Wellness Center carefully decides when and if MRI images are needed to guide the Pflugerville 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."