An MRI, which stands for "magnetic resonance imaging," is a device that creates an image of the body's internal structures through the use of magnetic waves. MRI machines are getting better all the time, and the quality of the images are impressive. We have conferred with doctors who can show us a three dimensional image of a neck, including all the ligaments, discs and other soft tissues, and move image around in many directions. So how does this affect an injury or workers' compensation claim?
The first thing to keep in mind that the MRI is a diagnostic tool that helps your doctors to investigate the nature and extent of injury. Doctors typically use the MRI to rule out a serious injury in order to develop a treatment plan.
Neck injuries are a good example. We have worked with many clients suffering neck injuries. Doctors will not order an MRI immediately unless there is a clear sign of serious neurological injury. In most cases, the doctor will take a conservative approach, allowing the patient to rest and heal, and try things like physical therapy or medication. If, after a period of time, the patient is still reporting certain symptoms, like radiating pain or electrical shocking sensations into the arm, numbness, or tingling, then a doctor will order an MRI.
When a doctor orders an MRI of the neck, he or she is looking to see if there is any damage to the joint structures that hold the neck bones in place, and separate one neck bone from the other. In between each neck bone is a disc that acts like a cushion. The disc is hard and fibrous on the outside, and moist and softer on the inside. Some doctors have described the inside portion of the disc as having the consistency of crab meat. When a human neck is exposed to sufficient force, the moist inner part of the disc can be pushed outside of the outer layer of the disc, which is called a disc herniation. Sometimes the force of an injury will make the outer part of the disc protrude, but the material in the middle of the disc does not break through. Other times, the disc may bulge as a result of trauma.
Aging and genetics will also cause wear and tear of the ligaments and discs in the neck, and an MRI can show this as well. Generally, doctors look at the color of the image as one marker to determine whether an injury caused the change on the MRI, or whether it was a degenerative change that happened over a long period of time. Sometimes it could be a combination of an injury making a degenerative change worse.
Even though MRIs are objective, radiologists will disagree on what caused a particular finding. Some radiologists do not believe that discs can herniate under force, and often find themselves consulting quite a bit for insurance companies. Other doctors will make their opinion based on what they see on the MRI, what the patient is saying about their symptoms, and what the treating doctor found in an office examination.
Whether it's an Oregon Workers' Compensation claim or an auto collision case, MRIs will usually address one or two issues. The first issue is whether the on the job injury or auto collision is the cause of an injury. A radiologist can often tell whether a finding on an MRI resulted from an injury event, or even if it was not, whether the injury event made some already existing finding on the MRI worse.
MRIs will also help lawyers prove whether an injury is permanent. For example, if someone suffers a significant disc herniation, they may need to have the disc removed and the two neck bones fused together. This is called a discectomy. The surgeon is basically removing a joint from your neck, and fusing two bones together. This kind of surgery permanently restricts your neck motion, and makes the adjacent joints work overtime to hold up your head. Those joints are now at increased risk for development of wear and tear damage, which we call arthritis, or degenerative disc disease.
If you have an Oregon or Washington auto injury claim, or an Oregon Workers' Compensation claim, you may have issues about whether your injury is causing something that is showing up on an MRI. Call us at 503-325-8600 if you have questions. We have learned a lot from doctors over the years, and help people facing these concerns all the time.