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  • harshjani
    Participant
    Post count: 31

    Hello,
    What are the diagnostic images are available to determine c1 c2 accessory ligament and alar ligament injury?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    The best tests for these ligaments are a complete history with the appropriate symptoms, X-rays with flexion/extension, an MRI focusing on the upper cervical spine (some MRIs do not include this area) and possibly flexion/extension limited CT scans. I will tell you it is exceedingly rare to find injury to these ligaments unless significant trauma occurs (ejected out of a car when not wearing seatbelt, motorcycle vs. car impact, fall from substantial height) or you have a metabolic disorder.

    There is a spurious test called the DMX or fluoroscopic video imaging of the neck with motion. I have never found this test to be valid or reliable and I know of no surgeon who uses this test but there are a few non-surgeons who use it.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    harshjani
    Participant
    Post count: 31

    What specific type of mri and ct scan?

    1.5t etc.
    Do you consider arthritis a metaboiloc disorder?

    harshjani
    Participant
    Post count: 31

    If you get to choose one of these dignostic images What dignostic method you choose to determine cspine abnormalities x ray or dmx ?why?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    DMX is an unknown and “findings” are overcalled by the “rare” radiologists who read these films. The amount of radiation exposure is not called for as the diagnostic benefit is not there for the amount of fluoroscopic time necessary to get motion films. Findings are spurious in my opinion.

    X-rays and an MRI are the best way to diagnose this disorder but do not get too fixed on occiput-C1 instability as a diagnosis as this diagnosis is exceedingly rare.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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