Why Radiologists Cannot Assess Excessive Motion: The Need for Specialized Testing

Introduction

Radiology Reads vs. Excessive Motion Testing

Radiologists perform quick, high-level evaluations of imaging studies, often spending only 30 to 45 seconds per X-ray. These evaluations are designed to identify major pathologies such as fractures, dislocations, or degenerative changes—not to assess ligament injuries or measure excessive motion.

What Radiologists Can See

• Obvious abnormalities like anterolisthesis (forward slippage) or retrolisthesis (backward slippage).
• Structural pathologies such as fractures or significant degenerative changes.

• The quantitative measurements of excessive motion, such as precise translation and angular findings at each vertebral level.
• Subtle ligament damage or instability, which requires detailed analysis across multiple motion units (e.g., C2-C3, C3-C4, etc.).
  
  

The Importance of Excessive Motion Testing

Excessive motion testing is not a pathology study; it is a functional diagnostic test that provides crucial information about the spine’s biomechanics. It identifies the presence and severity of ligament injuries, which are often the underlying cause of chronic pain, headaches, and other symptoms following spinal trauma.

What Excessive Motion Testing Measures

• Translation: How far one vertebra shifts relative to another during movement.
• Angular Displacement: The degree of abnormal rotation between vertebrae.

Why These Measurements Matter

Excessive motion testing allows doctors to:

1. Grade the Severity of Ligament Sprains: Determine if the injury qualifies as a surgical-level condition.
2. Assess Impairment Levels: Identify the long-term impact of the injury.
3. Guide Treatment Plans: Align treatment with clinical guidelines to ensure it is appropriate and effective.
4. Identify Related Injuries: Correlate ligament damage with potential disc herniations or facet injuries.
5. Support Legal Claims: Provide unbiased, measurable evidence in medical-legal cases.
   
   

Why Eyeballing Isn’t Enough

Even experienced clinicians cannot “eyeball” excessive motion accurately. While a trained eye might suspect instability, only a detailed measurement can confirm its presence and severity.

Analogy: The Echocardiogram

Think of excessive motion testing like an echocardiogram, which evaluates heart function. While you can visually observe a heart beating, you need precise measurements to determine how effectively it is pumping blood. Similarly, excessive motion testing freezes and measures specific moments of spinal movement to identify abnormalities.

The High Stakes of Ignoring Excessive Motion

• Misdiagnosis: Failing to detect ligament damage leaves patients with unresolved pain and instability.
• Improper Treatment: Without proper diagnosis, treatment plans may fall short, leading to chronic conditions.
• Legal Vulnerabilities: In medical-legal cases, inadequate documentation of injuries weakens claims and may reduce reimbursement.
  
  

• Ligament injuries often mimic symptoms of mild traumatic brain injury (TBI), such as headaches, dizziness, or blurred vision. Proper excessive motion testing can help correlate these symptoms with upper cervical ligament damage.
• Disc herniations without accompanying ligament damage are frequently considered pre-existing conditions, making it essential to document other tissue damage consistent with the mechanism of injury.
  
  

The Need for Unbiased, Independent Testing

In medical-legal contexts, excessive motion testing should be conducted by an unbiased, independent source to ensure credibility. Attorneys, insurers, and courts are more likely to accept results from an impartial provider, protecting both the patient and the doctor.

Best Practices for Excessive Motion Testing

• Use Specialized Services: Partner with organizations like Spinal Kinetics that focus exclusively on excessive motion testing.
• Avoid In-House Bias: Outsourcing testing ensures objectivity and professionalism.
• Correlate Findings: Combine excessive motion data with other diagnostic tools, such as MRIs, for a comprehensive understanding of the injury.
  
  

Elevating Professional Standards

Doctors who prioritize excessive motion testing are at the forefront of spinal injury care. They understand that ligament injuries are among the most serious and expensive conditions in the healthcare system. By using proper testing and documentation, these providers:

• Deliver better patient outcomes.
• Reduce long-term healthcare costs.
• Strengthen their reputation and credibility in both clinical and legal contexts.
  
  

Final Thoughts

Excessive motion testing is the gold standard for diagnosing ligament injuries and spinal instability. Radiologists cannot perform this level of analysis during standard imaging reads, and relying solely on eyeballing techniques is inadequate.

At Spinal Kinetics, we specialize in providing unbiased, independent excessive motion testing to help doctors accurately diagnose and treat spinal injuries. Our goal is to standardize spinal injury workups, ensuring that every patient receives the care they need and every provider has the tools to succeed.

If you’re ready to elevate your practice and deliver exceptional results for your patients, contact us today. Together, we can set a new standard in spinal injury diagnostics.