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  • Writer's pictureDr Josh Bonine DC

MISSED DISC HERNIATION IN THE EMERGENCY ROOM

MISSED DISC HERNIATION IN THE EMERGENCY ROOM

Properly documenting CAUSALITY is critical in the initial management of a personal injury case. Was there an injury sustained or not? From a medical-legal perspective, at the beginning, nothing is more important.


Many trauma patients are first examined in the emergency room. When they are released are you, as an attorney, confident they received a thorough evaluation and that when indicated, CAUSALITY was properly documented? The consensus on the national level is a resounding NO.



In a recent study by Schoenfeld, Bono, McGuire, Warholic, & Harris (2010), the authors inquire, “Thus, the question remains: does adding an MRI provide useful information that alters treatment when a CT scan reveals no evidence of injury” (p. 109)? They go on to state “In light of its ability to detect ligamentous, soft tissue, and osseous edema, many clinicians contend that the sensitivity of MRI for detecting injuries exceeds that of CT” (Schoenfeld et al, 2010, p. 111).


When a traumatically induced injury is examined, it is imperative that a complete and thorough examination be obtained by the doctor. This includes MRI which will show clinically significant injuries that are NOT diagnosed on a CT scan.


Reference:

Schoenfeld, A. J., Bono, C. M., McGuire, K. J., Warholic, N., & Harris, M. B. (2010). Computed tomography alone versus computed tomography and magnetic resonance imaging in the identification of occult injuries to the cervical spine: A meta-analysis. The Journal of TRAUMA, Injury, Infection, and Critical Care, 68(1), 109-114.


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