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I covered a lot of information about ligaments in the first 3 podcasts and then on the 13th podcast we talked a little more about ligaments. Ligaments are such a common injury that I would like to spend a little more time talking about ligaments and the repair process. I hesitate to say the healing process since this gives the idea that there is a good recovery with healing. That is not the case with ligaments and repair is maybe a more appropriate term. Today’s study w

The majority of people listening to my podcast will not be able to order advanced imaging of patients. Most of my listeners are attorneys and unable to order MRIs, but I wanted to take some time today and discuss indications for advanced imaging. I have worked with some attorney’s I am sure none that are listening to this podcast, but ones who demand MRIs on every case. This is dishonest and should not be done. We need a clinical justification for ordering advanced imagin

For the first 3 podcasts I covered a lot of information on ligament damage. The second podcast in particular I spent a lot of time talking about alteration of motion segment integrity or AOMSI. That podcast shows how we can objectively show catastrophic ligament damage. As a refresher AOMSI is when we have changes in the angle between the motion segments in the spine of over 11 degrees. AOMSI is also when we have translation forward or backwards of the vertebra by 3.5mm

The last podcast covered how injuries occur with no damage to vehicles and patients in collisions with no damage often go through more treatment than patients with damage to the vehicle. I would like to spend some time today going over the chances of being hurt in a low speed and minimal to no damage collision and how this compares to normal activities of daily living. Today’s study was published in 2021 in the International Journal of Environmental Research and Public He

We have spent the last 10 podcasts talking about injuries and what they mean to patients and how we can show causation. Today I want to talk about MVC’s with minimal damage to the vehicle. Like I’ve talked about in prior podcasts, I don’t like assumptions that are often used. I hear there was no damage to the vehicle and therefore there is no way the patient could have been hurt. I also hear reported that the vehicle was totaled and therefore they were really hurt. We ne

For the podcast I have gone over a few different research articles that discuss how to time date injuries with imaging and in particular MRIs. The last podcast discussed what a disc herniation might mean to a patient. I went over research showing the effects of a disc herniation when it takes the space of the spinal cord and nerve roots. The last podcast showed, if a disc herniation is compressing nerve tissue this will lead to cellular death and permanent nerve damage and

The last few podcasts have focus on disc damage and time dating injury based on imaging. We have not covered all the ways to time date an injury based on imaging. I wanted to spend some time today talking about what disc damage means to patients and not just the causation of the injury. I will have to spend a few podcasts on this subject as well. One common theme with disc herniations is real estate. Disc herniations can cause significant pain due to the recurrent men

The last few podcasts are all about time dating injuries with imaging. Is there a way to look at imaging and determine if we have a new injury that was caused by recent trauma or are we looking at pre-existing injuries. We have gone over multiple ways to help paint a picture of new vs. old. When we look at all the evidence it becomes easier to determine age of an injury seen on imaging. There have been articles published showing a certain percentage of the population ha

The last few podcasts have been about time dating injuries with MRI. Today’s podcast will not be specific to just MRI, but will be useful with CT and x-ray. Keep in mind that all methods for time dating injuries just help paint a picture. Will all of the evidence add up to show a new injury, or will the evidence stack up to show a pre-existing injury unrelated to recent trauma. Today I want to go over 2 separate studies. The first study is The diagnostic value of an x

The last 2 podcasts have discussed ways to help time date injuries with MRIs. We talked about modic changes, degenerative changes, and subjective radicular pain. Today I want to focus more on changes to the bone surrounding injuries. I want to go over Wolff’s Law and 2 separate research articles. Wolff’s Law came out in the 1800’s and says Bones will adapt to the loads under which it is placed. One of my favorite examples of Wolff’s Law is loss of bone density in astro

The last podcast discussed MRIs and findings of new vs old disc damage. We went over a lot of findings on MRIs of evidence to suggest new vs old injuries. The last podcast should be helpful with demonstrable objective evidence of injury and causation. In the medical legal world objective demonstrable evidence is often the key. What about subjective evidence? Does the way the patient experiences their injuries have an impact on diagnosis and a medical legal case? The stu

I have talked a lot about ligaments in the first 3 podcasts. When someone has a persistent or permanent injury following trauma in their spine I typically see ligament damage or disc damage. Disc damage and some ligament damage can be seen on MRI. MRI is a great tool to show demonstrable evidence of an injury. Today I want to talk about using an MRI to help with causation. The question I get asked a lot is: Is there a way to time date an injury with MRI? Time dating i

Today’s article will go along with the first 2 podcasts and discusses ligaments. The first podcast talked about the makeup of ligaments, how they get injured, what the inadequate healing process for damaged ligament is like and how to manage ligament damage. The second podcast was on the history of Alteration of Motion Segment Integrity or AOMSI and impairment ratings. Today’s article is Ligaments: A Source of Musculoskeletal disorders. This was published in the Journal o

Welcome to the second podcast. Today’s podcast will fit in well with the first podcast which was all about ligaments. The first podcast talked about the makeup of ligaments, how they get injured, what the inadequate healing process for damaged ligament is like and how to manage ligament damage. Today’s podcast will discuss alteration of motion segment integrity or AOMSI. The term AOMSI is used frequently in the person injury world. Today I want to talk about the origins

For the first podcase I am using Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics Published in The Open Rehabilitation Journal 2013 Hauser (MD neurologist), Dolan , Philiips, Newlin, Moore and Woldin. -The article starts with discussing ligaments function. Ligaments were once thought to be inactive structures, but they are in fact complex tissues- ligament mediated reflexive control- so important to unde