What type of Patient and Symptoms benefit from a DMX Study?
Determining the Best Diagnostic Test to order for different Symptoms.
Differentiate between Neurological vs. Sclerotomalpain (CAD/Whiplash) symptoms, to determine if a DMX, MRI or both are needed.
Why DMX shows more than X-rays
How to Order a DMX Exam
What type of Patient and Symptoms benefit from DMX Study?
Patients with “Whiplash” or Cervical Acceleration-Deceleration (CAD)
injuries and symptoms.
Neck ache
Neck stiffness with limited movement
Headache
Neck tenderness
Dermatomal / sclerotomal pain radiation
Dizziness
Increased pain with movement
Aberrant/Abnormal Neck Motion
Hypermobility of the Neck
Restricted Motion/Hypomobility
Definition of “Whiplash”
Whiplash is an Acceleration-Deceleration mechanism of energy
transfer to the neck. This may result from rear-end or side-impact motor
vehicle collisions, but can also occur during diving or other mishaps. The
impact may result in BONY or SOFT TISSUE injuries, which in turn may
lead to a variety of clinical manifestations. Therefore, injuries can occur
to the many different structures in the cervical neck, and create different
types of symptoms from “Whiplash” or Cervical Acceleration-
Deceleration (CAD) injuries.
The Clinician’s task is to sort out the symptoms and determine which
Diagnostic Test is best suited for the patient’s symptoms.In a recent post-mortem study of car accident victims, it was
concluded that:“Postmortem studies have found that after CAD 'whiplash' injuries,
ligamentous injuries are extremely common in the cervical spine and
that herniation of the nucleus pulposus is a rare event.”From this data, many car accident survivors with Whiplash/CAD
symptoms may benefit more from a DMX than an MRI.Clinicians need to determine from physical exam and clinical
history which test is appropriate, whether there are:
'Whiplash' symptoms requiring a DMX
Neurologic symptoms requiring an MRI
...or both exams
Each Diagnostic Modality has its benefits of diagnosing
different types of Injuries that can occur in CAD:
How to differentiate between:Neurological symptoms and referred Dermatomal/Sclerotomal
pain CAD/WHIPLASH symptoms, to determine if a DMX, MRI or both
are needed.
MRI pain = Neurological SymptomsSymptoms
Radicular pain- shooting pains to the arms and legs
Numbness or tingling sensations
Loss of feeling and other sensations
Causes
Disc Herniations
Spinal Cord Contusions and
Other related cord injuries
DMX pain = “Whiplash” SymptomsSymptoms
Neck ache
Neck stiffness with limited movement
Headache
Neck tenderness
Dermatomal / Sclerotomal pain radiation patterns
Dizziness
Increased pain with movement and Radicular pain with a negative MRI
Causes **
Ligament injury/instability
Facet Joint injury/instability
Muscle Injury
** The reason ligament and facet joint injuries cause pain is that these
structures are highly innervated and when stretching or injury occurs this
leads to activation of spindle fibers to the brain which then return a
dermatomal/myotomal pattern of pain to correlate with the level of the
cervical spine that is injured.
Why DMX shows more than X-rays:
Studies show plain cervical flexion/extension X-rays can miss almost 46% of findings that a DMX motion exam will show in car accident patients.
Static X-ray series shows only limited points of stress while DMX shows peak points and all points in-between, making previously undetected ligament injuries now observable.
The time delay between positioning the patient and taking static X-rays allows the muscles to re-align the spine and therefore sublaxations may not be observed.
Foramenal narrowings with motion are not seen on static X-rays.
Facet joint gapping and injury with motion are not seen on oblique X-rays.
Open mouth views taken with motion and lateral bending to diagnose C1-C2 instability are not performed by static x-rays.
Segmental motion and biomechanical abnormalities such as abnormal initiation of segmental cervical motion cannot be observed on single static X-rays.
Anterolisthesis and Retrolisthesis that would be called normal on static X-rays appear clearly abnormal when seen in motion.
Static X-rays cannot capture the uncoupling motion of the spinous processes.
Who Can Order a DMX exam?
Any Medical, Osteopathic or Chiropractic Physician
Where is the DMX exam performed?
You can make an appointment for our Mobile Diagnostic Van to come
directly to the treating physicians office,
or
Your patient can make an appointment to come to our Wellesley office
conveniently located off Route 128 at:
49 Walnut Park, Building #5 Wellesley, Massachusetts 02481or call us at:(339)-225-1720 or (781)-431-1070
How is a Study paid for?
We handle all the insurance Billing
Most PIP insurance covers the exam
Health Insurance covers the exam if the $2000 PIP insurance is exhausted
Exams can be paid for “out of pocket”
DMX exams are significantly less than the cost of an MRI
Who Inteprets the DMX Study?DMX studies are interpreted by Board certified Radiologists with special
expertise training in DMX.
DMX interpreters utilize the same standards of radiological interpretation
common to plain film studies to interpret DMX images. The difference
is that DMX results in far more imaging choices in far more postures
or positions. Additionally there is value in observing the actual motion.
What is a Sample Report Like?Click here for a sample report.
