The Shaw Chiropractic Offices are equipped
with state-of-the-art diagnostic testing
equipment. Some of the diagnostic procedures
available through our offices are listed
below.
X-Ray
Plain film radiology is used for the
assessment of bone and joint integrity.
This routine procedure is used on patient
involved in trauma to rule out fractures,
dislocation, infection and primary bone
pathology. In the chiropractic practic
e
it is helpful to identify contraindications
to manipulative therapy.
Dynamic Motion X-ray (DM
X)
Also known as fluorovideo Motion Analysis (FMA), Video Fluoroscopy
and
Cineradiography, it has the ability of recording
spinal motion x-rays on video tape. This is useful in evaluating
kinetic and kinematic abnormalities. It is extremely sensitive
for the evaluation of ligamentous integrity. This test is most
appropriate for patients who have sustained acceleration/deceleration
trauma when there is the liklihood that the anterior and posterior
supportive structures of the spain have been put under excessive
stresses. It is the single most valuable test in identifying
abnormalities of joint coupling which is the underlying cause
of spine pain from biomechanical origin. Recorded on video it
is a powerful forensic tool for demonstrating to a lay person
the results of trauma.
Electromyography
(EMG)
EMG is used to identify areas of physiologic
muscle changes often associated with
myopathy, neuropathy and motor-neuron
junction disease. In the trauma setting
it works together with Nerve Conduction
testing to identify areas of traumatic
nerve damage.
Nerve
Conduction Testing (NCT)
Nerve Conduction Testing is used with
EMG to determine if damage to nerve
and muscle is the result of nerve, muscle
or central nervous system lesions.
Somatosensory
Evoked Potentials
Similar to EMG and NCT this test is
a measure of electrophysiologic function.
This test has the capacity of identifying
sensory abnormalities of the nerve roots
and central neurologic pathways which
are commonly damaged in traumatic injury.
Bi-directional
Doppler
This type of doppler testing is used
to identify areas of arterial and venous
disease. Identification of Deep Vein
Thrombosis, arterial stenosis and claudication
allows for safer treatment management
of injured patients. Testing of the
blood supply to the brain and extremities
offers valuable information both for
clinical management and malpractice
risk management
Plethysmography
Plethysmography (photo and pneumo)
allow the physician to identify areas
of diminished peripheral vascular blood
flow. This is particularly valuable
in isolating the origin of symptoms
in patients exhibiting signs of thoracic
outlet syndrome (TOS). TOS is one of
the most commonly overlooked conditions
in patients with upper extremity sensory
complaints and trophic changes.
Spirometry
Patients beginning an aerobic rehabilitation
program should be assessed for respiratory
function to assure program safety. Routine
use of spirometry will prevent setbacks
and allow for optimal resolution.
Functional
Capacity Examinations (FCE)
FCE testing helps to quantify the post
management capacity of patients to perform
tasks. The FCE examination may take
between 2 hours to 2 days and may assist
with return to work determinations and
permanent impairment evaluations. It
is equally beneficial in identifying
patients who are symptom magnifiers,
embellishers, malingerers and/or exhibiting
factitious disorders.
Computerized
Muscle Testing (CMT)
CMT provides valuable information about
the patient's capacity to perform joint
movements against resistance. CMT procedure
graphically present information regarding
muscle strength during static procedures
which are valuable in rehabilitation
program design and ultimately impairment
determination.
Computerized
Inclinometric Examinations (CIE)
CIE examinations provide excellent
documentation and tracking of patient
progress regarding range of motion simple
and compound joints. CIE testing requires
that validity parameters be met before
determining loss of function and it
is specifically this validation that
makes it so valuable in the medical
legal arena.
Computerized
Algometry
Algometry is a measure of a patients
pain threshold. Like the CIE examination
it requires that specific validity parameters
are met and therefore is valuable for
identification of non-organic pain as
well as conditions such as fibromyalgia.
Bone Densitometry (DEXA)
This testing is done to measure bone mineral content of
patients. In the chiropractic setting it is used for general
bone health assessments as well as to rule out contraindications
to spinal manipulation. Conditions such as osteoporosis,
osteomalcia, osteopenia from a multitude of renal, nutritional
and metabolic diseases can measured and used in the management
of patients
Diagnostic Ultrasound (Musculoskeletal
and Vascular)
Although ultrasound was considered controversial for musculoskeletal
applications in the seventies and early eighties, the development
of better
microelectronic
processing
and
tissue harmonics has lead to advancement in image quality
and resolution. The newer diagnostic ultrasound machines
have
the ability
to visualize muscle, tendon and ligament tears with sensitivity
which is greater than MRI according to some researchers.
Recent applications have also been promising for spine imaging.
Sagital canal measurements for spinal stenosis as well as
facet joint imaging for
inflammation and healing are becomming more widely utilized.
Of course, diagnostic ultrasound has been used for years
in multiple clinical settings ranging from obstetrics to
cardiology. Vascular applications include color flow doppler
which is valuable in determining risk factors for conditions
such as those associated with stroke, aneurysm and deep vein
thrombosis, all of which are concerns of the chiropractic
physician.
Thermography has the unique ability of measuring the physiologic
status of both the musculoskeletal and neurological systems.
Thermographic testing measures the temperature of the surface
of the skin. This is a refelction of the quality of vascularization
and capillary perfusion to the skin surface which is under
the influence of the sympathetic
nervous system. Conditions such as Reflex Sympathetic Dystrophy
(RSD) resulting in Causalgia and Sudecks Atrophy can be visualized
in color. There are over 6,000 medical publications on the
efficacy of thermography in applications including breast
cancer screening, sympathetic nervous system disease, muscular
and neurologic injuries. Unfortunately, the testing is not
reimbursable by carriers and as a result is not used frequently
in medical practice.
Thermography measure the When interpreted
by a
board certified thermographer
the
test
can
greatly assist
the doctor
and
attorney by graphically
demonstrating the abnormalities present. Juries are particularly
impressed by the color representation of soft tissue damage.
Procedures such as MRI, CT scans
and bone scans are referred to local
facilities which have a working relationship
with our offices.
Thermography has the unique ability of measuring the physiologic
status of both the musculoskeletal and neurological systems.
Thermographic testing measures the temperature of the surface
of the skin. This is a refelction of the quality of vascularization
and capillary perfusion to the skin surface which is under
the influence of the sympathetic
nervous system. Conditions such as Reflex Sympathetic Dystrophy
(RSD) resulting in Causalgia and Sudecks Atrophy can be visualized
in color. There are over 6,000 medical publications on the
efficacy of thermography in applications including breast
cancer screening, sympathetic nervous system disease, muscular
and neurologic injuries. Unfortunately, the testing is not
reimbursable by carriers and as a result is not used frequently
in medical practice.