The prevalence of positive imaging findings on MRI scans ordered by chiropractic versus medical providers.
OBJECTIVE
To determine if there is a greater yield of pathological findings identified on MRI scans of patients referred by chiropractors as compared to those referred by allopathic providers.


METHODS
MRI reports authored by medical radiologists from two independent MRI centers in the Denver metropolitan area were analyzed retrospectively for pathological data related to the spinal regions studied. A pathological report data sheet was used to record pathological findings in 22 different categories. A total of 150 reports from each provider group were reviewed.


RESULTS
Of the 22 pathological conditions studied, a statistically significant difference between doctor of chiropractic and medical doctor referrers was identified in 4 categories: central spinal canal stenosis, lateral stenosis, facet arthrosis, and negative report. The most common primary diagnoses given for MRI referral were low back pain/sciatica, neck pain, and extremity pain. Seventy-four percent of the reports evaluated were performed on patients referred with a diagnosis of pain. In 3 of the 22 categories (14%), the medical doctors had a statistically higher pathological yield than the chiropractors. However, in 4 of the 22 categories (18%), the chiropractors had a statistically higher pathological yield. In 18 of the 22 categories (82%), there was no statistical difference between the two provider groups.


CONCLUSIONS
The data presented in this study suggests chiropractic and medical providers are compeer at ordering MRI for suspected pathological findings.
Morries
Larry
L
Practice of chiropractic, Englewood, CO.
Yochum
Terry
T
Barry
Michael
M
Slizeski
John
J
Freuden
Donald
D
Danielson
Clark
C
Radiology. 2003 Apr;227(1):113-7
12668743
J Manipulative Physiol Ther. 1998 Mar-Apr;21(3):173-6
9567237
N Engl J Med. 1994 Jul 14;331(2):69-73
8208267
Br J Gen Pract. 1999 Jul;49(444):559-61
10621993
Spine (Phila Pa 1976). 1994 Jun 1;19(11):1207-12; discussion 13
8073311
J Natl Med Assoc. 2000 Dec;92(12):573-8
11202760
Radiology. 2002 Mar;222(3):615-8
11867774
J Gen Intern Med. 1992 Sep-Oct;7(5):486-91
1403203
J Fam Pract. 1993 Mar;36(3):281-5
8454974
J Bone Joint Surg Am. 1995 Nov;77(11):1631-8
7593072
Can Assoc Radiol J. 1994 Apr;45(2):117-23
8149266
J Bone Joint Surg Am. 1990 Sep;72(8):1178-84
2398088
AJR Am J Roentgenol. 2002 Jul;179(1):27-31
12076898
Health Aff (Millwood). 2003 May-Jun;22(3):89-105
12757275
Spine (Phila Pa 1976). 1996 Dec 15;21(24 Suppl):2S-9S
9112320