J Manipulative Physiol Ther. 1998 Mar-Apr; 21(3): 173-6.

Chiropractic utilization of lumbar magnetic resonance imaging: how accurate are we compared with other specialties?

Kilmer SE.

OBJECTIVE: To determine, through the review of lumbar magnetic resonance images (MRIs), which specialty ordering these scans was more successful and accurate in coming up with "positive findings" that would warrant the use of the modality. Such data can demonstrate to managed care organizations and insurance companies that chiropractors have a good working knowledge of when to use this test and that the profession deserves the right to direct access to MRI. DESIGN: Seven hundred and two lumbar MRIs taken over a 3-yr period were reviewed. A list of seven criteria was made consisting of (a) disc derangement, (b) stenosis, (c) trauma, (d) tumors, (e) hematologic and vascular, (f) infection and (g) metabolic-endocrine disorders. Scans found to have one of the seven categories were listed as positive findings. The number of positives were then entered under each separate specialty group and a percentage was calculated for each. RESULTS: This study showed that DCs fared better than all providers except for oncologists and general surgeons. Chiropractors fared 2.42% better than orthopedists and 10.06% better than general practitioners, who, ironically, DCs must rely on at times for authorization of MRIs in certain managed care situations. CONCLUSION: It would be fruitful to conduct similar studies of this type, thus obtaining a larger database of information that reflects more accurate numbers nationwide and documents chiropractors' working knowledge of when to use this imaging modality.