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    Blog / Diagnosis / Page 14

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Loss of curve and neurologic problems
July 18, 2015

MVC can significantly change your patients cervical lordosis. So what, right? Well, many studies suggest this is a significant pathology that can lead to further complications. This is improtant to understand so 1) we can get our patients the treatment they need, 2) try to prevent our patients from getting worse 3) explain to your patients, insurance companies and attorneys… Read More

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Sclerotogenous pain pattern
July 18, 2015

Facets and ligaments will not be as “clear” as radiculopathy along a specific dermatome. We need to be aware of this. Many patients after a crash can suffer facet damage and if the damaged facet is in the neck, the pain may be near the shoulder blades. This is an important clinical finding that if documented can give us more… Read More

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Facet injury and head position
July 17, 2015

Head position is an important factor to know in a car crash or trauma. You have to make sure you ask your patients about this. Were your patients looking at the car coming at them? If so, what position was that? This is another piece of evidence to lead us to a probable pathology, such as facet and or ligament… Read More

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Research evidence that MVC causes ligament damage.
July 15, 2015

When asked “why” are we treating our patient, or how do you know this injury is from this crash, it is important to understand many different areas of crash dynamics and associated pathologies. Here is a study for you to include in your notes, patient education, expert narratives, etc to explain why you came up with a diagnosis of instability,… Read More

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Loss of ligament strength after a MVC
July 12, 2015

Information like this is important to understand. This can dramatically affect your patients ADLs and treatment, both in terms of what to expect and for how long. Having a weaker neck after a crash may mean your patient is more susceptible to flare ups and why some activities are harder for them since the crash. Notice this is not a… Read More

Documenting cervical instability on flexion and extension
July 12, 2015

You need to objectify your patients injury and your diagnosis. By utilizing the research and guidelines (you will have access to this if you join the site) you will be able to explain why your patient hurts and needs care. Instability is a very serious injury that can lead to further chronic problems and long term treatment. Instability is also… Read More

X-Ray digitization on a lateral cervical X-ray
July 12, 2015

I digitize every X-Ray I can. Why? I feel with out it, it is like using a blood pressure cuff, but not having a dial to objectify the numbers. Having the information to tell us as doctors, what a normal or abnormal spine is (I have posted research to support this) is important. This is how we can document why a… Read More

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Loss of Curve and MVC
July 8, 2015

Again, as a doctor you need to be specific in your diagnosis. 1) that is our job 2) It allows us to help the patient better understand what is wrong, 3) an insurance company will have to argue that the diagnosis is wrong which is difficult. Here is a picture that shows a loss of cervical curve is common in… Read More

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Here is a study showing facet damage in a MVC
July 6, 2015

Facet joints are pain generators in the neck and can be a reason your patient has pain. You need to be sure to evaluate these joints and document it in your notes. Insurance companies will argue almost all injuries, but you need to explain how and why you diagnosed a certain pathology such as a facet injury. I have put… Read More

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Would You Have Missed This Injury?
July 1, 2015

This patient was involved in a MVC. He complained of headaches and neck pain. Sounds like a “typical whiplash” patient, no? Well, he was evaluated and told he had “whiplash”. This patient came to my office and during the initial evaluation and history, I concluded that he had a specific, potentially more serious injury. I am glad I knew that… Read More

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Anterior Head Translation, Abnormal Flex/ext, MRI, and Measurements
February 12, 2019

Hello Professionally Integrated, Here is another video and break down of a paper to help educate your patients and improve documentation to help validate your care. In this paper that authors look at an evaluate many MRIs and they measure many areas to look at the difference between patients in pain and those not in pain. Understanding these findings help… Read More

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Multiple Crash Factors, Chronicity, And “Low Impact” Injuries.
January 24, 2019

Hello professionally integrated, There is a great study that shows many factors are important from a clinical perspective. This paper discusses about  the need for appropriate diagnosis, why somebody types may be more hurt in a crash, leading to significant injuries that can lead to disability.  As a GOLD OR PREMIUM member you have access to papers and videos like… Read More

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Alar Ligaments, and Head Rotation in MVC
January 9, 2019

Hello Professionally Integrated, So many different injuries can occur in car crashes. Body and head position can play a major role into potentially increasing damage to certain structures of the neck. As a member, you have access to this information to keep you informed which will only increase your confidence leading to excellence. Here is a paper where the authors… Read More

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What Areas Get Damaged After A Crash Causing “Back Pain”?
November 2, 2018

Hello Professionally Integrated, Here is a paper where the authors looked at what areas cause pain in e lumbar spine AFTER a car crash. You can clearly see the pain is not diagnosed as “whiplash”. By understanding where the pain generator is, we can get a specific diagnosis that can lead to a better treatment plan. Lets take a look… Read More

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Instability and Long Term Pathologies
September 22, 2018

Hello professionally integrated, Here is a paper where the author discusses many papers that he has published on cervical and lumbar instability and the long-term consequences of this pathology. Many docs are taught to identify instability to increase the value of the motor vehicle claim. However, many docs do not understand what the long-term implications are and what we can… Read More

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Majority Of ASYMPTOMATIC Individuals Have A CERVICAL LORDOSIS
July 29, 2018

Hello Professionally Integrated, Here is a paper where the authors compared the sagittal alignment of 1026 asymptomatic individuals. Many people in the health care profession make statements like the “cervical curve has no clinical implication”, despite lots of evidence. In fact, on this site we have LOTS and LOTS of papers that show what happens with a loss of the… Read More

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WAD patients MRIs.
July 23, 2018

Dear Professionally Integrated, Here is a paper that shows differences on MRI’s in the cervical spine between crash patients and non crash patients. This is a significant finding and we should start asking our MRI radiologists if they can start mentioning this finding so we can document it and educate our patients. Plus, this study also shows that a LARGE… Read More

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Oblique MRIS?
July 15, 2018

Hello Professionally Integrated, Here is a video and FULL PAPER on a new view to maybe ask for when ordering a cervical MRI when the patient has radiculopathy. I already called my local MRI center and after I sent them this link, they agreed to start doing them. I am also adding in my videos a section on “How to… Read More

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Disc Degeneration and Lumbar Lordosis
July 3, 2018

Hello Professionally Integrated, Here is a paper and video that I break down as I feel it will lead to better long term outcomes, and improved documentation to help validate our care. I have also added in a “HOW TO IMPLEMENT IN YOUR PRACTICE” section in the video where I show you how I use this paper to educate my… Read More

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TMD, Car Crash, “low impact” and Disability and Exam
April 30, 2018

Dear Professionally Integrated, Here is a study that shows car crashes, even “low impact” crashes, causes jaw dysfunction as well as damage to the upper cervical spine, and how the jaw correlates to the upper spine. This study also shows how “low impact” caused significant damage to the occupants. I have used this study to present to my patients and… Read More

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LOSS OF CURVE CORRELATED TO DECREASED BRAIN BLOOD FLOW
February 1, 2019

Hello Professionally integrated, Here is a paper that my wife and I published along with  other wonderful doctors. First off, I would like to say thank you so much to the GOLD and Premium members.  Your support of this site has  allowed us to fund a study like this. We took multiple patients with abnormal cervical curves and did MRI… Read More

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Ligament Injury, Healing, Treatment, And Imaging
November 15, 2018

Hello Professionally Integrated, Here is a great video you need to implement for patient education and VALIDATING your care.  As a member you will be given what you need on a “silver platter” to educate, document, and increase your referrals based on your expertise.     Abstract: Ligament injuries are among the most common causes of musculoskeletal joint pain and… Read More

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Car Crash and Change in Blood Velocity
May 28, 2018

Hello Professionally Integrated, Here is a paper where the authors evaluated many different changes associated with a car crash, one of them being a change in “Blood Velocity”. I hope you have always heard me say that “whiplash” is NOT a diagnosis, but a mechanism of injury. ‘Whiplash” can cause no injuries or death and everything in between. Be sure… Read More

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“Low Impact” and death and Injury.
May 22, 2018

Dear Professionally Integrated, Here is a paper where the authors examined a patient who was in a “very low impact” collision that caused a VERY serious injury. I use this paper in my notes and education of patients that no link has been made to car damage and bodily injury.  This paper also discusses how important other factors are in… Read More

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Spinal Curve Changes, Pain, and Imaging
April 21, 2018

Dear Professionally Integrated, Here is a study where the authors looked at THOUSANDS of spinal images to determine if a change in the spinal shape leads to pain, dysfunction, and a change in the quality of life. Many providers feel a change of the spinal shape may be “normal” for a person and therefore treatment to address these changes is… Read More

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INSTABILITY AND FINDINGS
March 28, 2018

Hello Professionally Integrated, Here is a paper and breakdown for your notes and education. The authors looked at multiple criteria on what is needed to properly evaluate instability in the cervical spine. The authors did not mention C1/2 translation, but I have a paper on that topic coming out soon.  Be sure to do a FULL examination, and history as… Read More

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Diagnosis
January 23, 2018

Hello Professionally Integrated, Here are some diagnosis’ that I would like you to look for in a trauma, or pain patient, as A LOT of the research (much of what is on this site) suggests that many areas can be damaged. Please watch this video for more information . . . You either need to log in or a different… Read More

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Modic Changes And Loss Of Curve
January 12, 2018

Hello Professionally Integrated, Here is a great paper that I feel we should explain to our patients about the long term consequences if we do NOT improve the shape of their spine. “The aim of this study is to investigate the relationship between the Modic changes (MCs) and sagittal parameters of the cervical spine.”   “We conducted a retrospective review… Read More

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Degeneration and Abnormal Curve
January 1, 2018

“Five hundred digital sets of standing A-P lumbo-pelvic and lateral lumbar radiographic images were randomly selected according to a computer-generated list and analyzed retrospectively from a pool of approximately 1300 radiographic series in the RMIT University Teaching Clinic archives. All radiographs were de-identified except for date of birth, gender and date of examination. One hundred ninety nine sets of images… Read More

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Cervical Sagittal Balance and Clinical Practice
December 5, 2017

Hello Professionally Integrated Care! Just take a look at the title of this paper. Here are surgeons explaining how an abnormally shaped neck leads to bad health!! Why does some of our profession ignore a fully subluxated neck? Why do we listen to insurance companies dictate how much care we should provide if most of the research completely disagrees with… Read More

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