If you have been involved in an accident of any kind you may undergo diagnostic testing at some point to identify the nature and extent of your injury. The most common diagnostic tests in personal injury cases are X-rays, MRI’s and CT scans. X-rays are most commonly used to identify and/or rule out fractures and broken bones. MRI’s are often taken for a close look of a muscle or tendon injury. For example, an MRI will be used to diagnose rotator cuff tears of the shoulder, or ligament tears in knees and ankles. An MRI will also be used in cases of serious injury to the neck or back to diagnosis disc injury or herniation. Finally, a CT scan is most often used to diagnosis head injuries such as concussions or bleeding on the brain. A CT scan may also be used to identify and/or rule out internal injury such as injury to the lungs, kidneys, etc.
These tests might be taken at any time during the treatment for your injury. These tests may be taken at the emergency room following a serious auto accident or may be taken after your treatment has already begun. If you are not responding to treatment or your condition worsens after treatment has already begun, then a doctor might order an MRI or other test to ensure that the injuries are not more serious than previously believed.
It is important to be aware that all of these tests, in particular, X-rays and MRI’s, are subject to incorrect readings and mistake. X-rays taken immediately after an accident may often be incorrect because swelling around the fracture makes it very difficult to accurately see the bone. Last year, I represented a gentleman who was rushed to a Massachusetts emergency room from the site of a very serious car crash. The ER took multiple X-rays but failed to identify any fractures. A week later, my client’s primary care physician ordered another set of X-rays which revealed a fractured sternum and multiple broken ribs. Similarly, I currently represent a woman who fell down a flight of stairs breaking her ankle. This fracture, however, was not identified at the emergency room. It was only identified by an orthopedist almost 3 weeks later.
MRI’s are also imperfect. On occasion, the doctor interpreting the films will actually say in the notes that the test is “inconclusive” or that there is a “possible” fracture or herniation. Of course, inconclusive and possible are unhelpful terms during a personal injury lawsuit. When this occurs, it may be best to hire an expert witness to re-interpret the films.
Like X-rays, MRI’s taken weeks or months apart may show different results. The injury was likely always there but wasn’t seen by one doctor. There may be a number of factors for an incorrect diagnostic reading:
- Physician error or inexperience;
- Poor film or low resolution;
- Modality used was one not likely to identify an abnormality;
- Small injuries are either misinterpreted or simply missed.
If you are still in pain, seek treatment and if that treatment is not working, seek a second opinion. I do not give this as medical advice, but simply as safe advice that will help ensure that your injuries are accurately diagnosed and treated. A full and accurate understanding of the nature and extent of your injuries is also critical to ensuring that you receive everything that you are entitled to in your personal injury claim.