Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 324

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

"MRI Spine Interpretation"


I just received this response about the MRI course I am teaching in New Jersey from a local chiropractor who was responding to an invitation:

 
"Are you looking for a medical challenge. ???  Really I know we need a new challenge but really.   Patricia"
 
My response:
 
"I don't understand your comment. Chiropractors are responsible for the condition and care of their patients and research has shown that general radiologists have a 42.3% error rate in reporting MRI findings. That is the opinion you are trusting when delivering a high velocity thrust (adjustment).  
 
I would hope that you want to be able to at least understand the basics of the MRI interpretation so that you can protect your patients first and your license, practice and family second...or...you can simply abdicate that responsibility to someone showing a 42.3% error rate...and gamble...really!!!
 
My goal is to protect your patients and you, your practice and your family through practicing from a level of clinical excellence vs. "Russian roulette" in hoping the radiologist got it right.
 
I don't know what your goal is. You get to chose...Mark"
 
Being able to interpret MRI is critical. This past weekend, one of our doctors who hurt himself went for an MRI and ignored my instructions to get the MRI from a place I know well and know practices from a posture of clinical excellence. He went to a local center because he knows the owner and didn't want to take the extra step and go elsewhere. 
 
The result: When I went online with him to review the disc he had in his computer, I said, "How many slices are through the disc?" His answer, "One." 
 
I told him that not only was there one slice, but they took the wrong angle and caught too much bone in the slice, therefore making the sequence incomplete to get an accurate read. In addition, the MRI facility advertises that it is American College of Radiology (ACR) certified with 3mm slices. They are taking 4-5mm slices and do not render complete images to conclude an accurate read. The reporting radiologist diagnosed an extruded disc, that is a possible surgical disc. However, I didn't see anything that could be conclusively diagnosed with this incomplete study.
 
Again, our doctor knew better because he has taken the courses, but neglected to heed the most important advice, slice parameters and the locations of those slices. The reporting radiologist from what I read, falls into the 42.3% error rate. 
 
So...Patricia...I appreciate you wanting to not do anything medical, BUT...I chose not to play "Russian roulette" with my license. How many of you are just like Patricia?
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