Digital Motion X-rays (DMX)

Ligament injuries are extremely common in vehicle related accidents. Although ligament injuries can occur throughout the body during whiplash, the most commonly injured area is the neck. The ligaments can either be partially torn or stretched. Either way, they are not able to perform their normal function of stabilizing joints. Complete tearing of ligaments does occur in the shoulder and the knee (always requiring surgical repair to stabilize the area and regain full function). It does occur in the neck but, unfortunately, these patients almost always die at the scene due to severe spinal cord injuries.

Cervical MRI scans are very effective at diagnosing disc injuries (also very common in all forms of accidents) and the complete ligament tears that occur in the shoulder or knee. However, they are extremely poor at diagnosing the partial ligament tears and ligament stretching, which are by far the commonest neck injuries seen in automobile accidents. These are commonly called “soft tissue injuries” and usually downplayed as “relatively minor” because they could not be adequately visualized on more commonly used radiological studies. Ligament injuries, however, are far from minor. They are painful and permanent and cause significant decrease in function as well as enjoyment of life. Injured patients in the past have never been adequately compensated for such injuries because “they could never been seen or proven on any kind of study”.

DMXs are extremely accurate at diagnosing these injuries. This not only validates the patient’s pain, offers specific treatment options as well as allows the injured patient to be more adequately compensated for the injuries that they have sustained.

The basics of treatment include immobilizing the area in the acute phase (first three to six weeks) to prevent any additional injury to the ligament. In the neck this would entail the use of hard and soft cervical collars. Patients are then shown segmental stabilizing exercises to provide as much support as possible to the joint that can no longer be adequately stabilized by the permanently injured ligaments. These exercises are performed four to six times a day after careful instruction by a skilled physical therapist. Maximum stability with this form of management takes approximately three months. If the patient’s symptoms remain unacceptable at this time, the patient might be a candidate for prolotherapy. This is the injection of concentrated glucose into the ligaments. As there are 22 ligaments in the neck, this usually requires between 50 and 100 injections at each setting. These are usually performed on a monthly basis for six to nine months, by which time maximum additional stability of the area is obtained. It is important to note that, even in the best-case scenario, the patient will continue to have ongoing symptoms indefinitely. Our goal is to limit the patient’s pain and the interference with their daily activities.

At the present time there are only two MD-owned DMX machines in the entire State of Florida, and Medig Imaging in Gainesville is one of them. If you have been involved in a vehicle related accident and have persistent headaches and neck pain, and have an unremarkable neck MRI, then you are a candidate for a neck DMX study. The amount of radiation is approximately the same as a normal neck x-ray series. The machine is “wide open” and does not cause any challenges to patients that have claustrophobia. Please contact our Gainesville office at (352) 374-2818), and we will be happy to assist you in scheduling this procedure.

A Better Way to Get Better,
Adrian Lewis
Adrian Lewis, MD