While the DMX is heavily used for cervical studies of the neck, many have used the DMX to evaluate TMJ syndrome, shoulders, knees, ankles, hips, elbows, wrist and hands. Due to the low radiation nature of the DMX, Lumbar studies maybe limited based on the size of the patient.
Why is a Digital Motion X-ray more expensive than a regular x-ray?
The cost disparity between a Digital Motion X-ray (DMX) and a regular X-ray stems from the advanced nature of DMX imaging, aligning it with other specialized techniques such as MRI, CT scans, and Fluoroscopy. The equipment and time required for DMX evaluations are inherently more expensive to acquire and maintain compared to standard X-rays, contributing to the higher overall cost.
How long is a DMX evaluation?
Typically, each evaluation takes approximately 30 minutes. Please allocate an hour to account for any potential complications that may arise. In certain cases, sections of the evaluation may need to be repeated due to pain or other circumstances. Additionally, we conduct a thorough review of the captured video during your visit to ensure we have obtained the necessary images and to address any questions you may have.
Will I receive a copy of my DMX and report?
Certainly! This is always part of our service. You will receive an digital copy, and we will also send copies to those individuals you have authorized. We recommend keeping your own copy to share with any additional healthcare providers you may encounter, thereby avoiding any extra record retrieval and submission fees.
Do your reports include a mensuration analysis?
Every cervical X-ray at our facility includes a mensuration analysis. Unlike other providers who may charge extra for this service, we believe this report is crucial for a comprehensive cervical DMX assessment. There is no additional charge for this detailed reporting. For extremity reports, a mensuration report is not typically included as measurements in these areas are generally unnecessary.
It hurts when I move. I found other imaging to DMX that offers passive motion, wouldn't that be better?
While a comfortable evaluation is desirable, the crucial question to ponder is this: Would you prefer to observe your joints in action when mechanically supported by an external mechanism, or witness their performance solely relying on your body's supporting tissues? While there are benefits to a passive range of motion joint assessment, when it comes to evaluating ligament integrity, the most effective approach is to witness it in action without external support. This provides a more accurate understanding of the dynamic functionality of your ligaments.
Is this procedure covered by my insurance?
This is undeniably one of the most frequently asked and challenging questions to address. While patients are understandably hopeful, the complexity of benefit structures within the insurance industry makes it difficult to predict coverage definitively. In reality, very few insurance plans cover this service, and most do not. However, it's important to note that we do bill auto insurance for personal injury cases, and they typically provide coverage.
We will furnish you with a statement that can be submitted to your health insurance company for potential reimbursement. It is advisable to err on the side of caution and assume that you may need to pay out of pocket, rather than presuming your insurance will reimburse you. This approach ensures that any reimbursement from your insurance comes as a pleasant surprise rather than an unexpected disappointment in the event of a denial.
I've heard that a DMX is effective for assessing ligament damage, but since x-rays don't display ligaments, wouldn't an MRI be a better option for visualizing ligaments?
MRIs excel in visualizing soft tissues like ligaments and are invaluable for identifying soft tissue pathology, providing detailed insights into the extent of ligament tears. However, their limitation lies in their inability to assess how well a ligament is stabilizing a joint. Ligaments play a crucial role in maintaining joint stability during movement. While an MRI can show a torn ligament, it may not reveal whether the ligament is effectively stabilizing the joint. An overstretched ligament, though appearing normal on an MRI, could be failing in its role. Unlike MRIs, Digital Motion X-ray (DMX) uniquely allows patients to move through their full range of motion while images are captured. This dynamic capability sets DMX apart, providing a more accurate assessment of ligament stability by observing joint movement, which static imaging methods like MRIs cannot achieve.
Are joints slipping over others, as detected by regular X-rays and MRIs, indicative of ligament instability? If so, what's the necessity for a DMX?
While regular X-rays and MRIs may identify slippages that are assumed to indicate instability, the full extent remains unclear without observing the joint in full motion. A DMX precisely reveals when, during motion, a joint becomes unstable, offering a comprehensive view of the severity and the specific ligament involved. Our radiologist measures how much your ligament has been stretched and record the measurements in the mensuration report Unlike static imaging, DMX captures instability at any point during the joint's range of motion. Even with stress X-rays, where patient positioning can cause guarding and pain, DMX typically captures instability before protective measures are taken. Our picture-in-picture technology also captures the patient's facial expression at the moment of pain, providing a more nuanced understanding of the instability.
Others claimed to offer Motion studies, what makes your service unique?
Don't be fooled. Digital motion X-ray has been tried and true for over 20 years. Some claim to be offering a DMX, service, but are not actually using a DMX system. A DMX system captures real time evaluations. The DMX system is trusted by many top instability providers and has been used as the gold standard in a 10 year instability study. Additionally, our system uses a fraction of the radiation required by other imaging. In fact, a full cervical DMX study which has close to 3000 images in real time, uses no more radiation that a standard 7 view cervical x-ray.
My Doctor is wanting to receive the DMX in DICOM format. Do you provide this?
Unfortunately, no. DICOM does not support true video; it offers a simulated video more akin to a slide show. The crucial image frames are selected, measured, and added to your report. Individuals seeking DICOM can utilize the report, as it integrates easily into Electronic Health Record (EHR) systems. Converting a full DMX video to DICOM would result in an enormous file size and require extensive processing for viewing. Most providers preferring DICOM create a separate patient file outside their EHR system and reference it within the EHR. This allows them to use the report in the EHR while still having access to the complete DMX video. Notably, if a provider claims to convert a full DMX video to DICOM, it suggests they may not be using a genuine DMX system, as the conversion process is impractical due to the sheer volume of images.
Is DMX considered an antiquated technology?
In some respects, yes, and in others, no. The origins of X-ray technology trace back to motion X-rays used for entertainment at fairs and even to assess how well shoes fit. However, this lighthearted approach took a serious turn when the health risks associated with excessive radiation became apparent. While hospital-grade fluoroscopic imaging still exists, it's used sparingly due to its significant radiation output. In traditional fluoroscopy, where the patient stays still and the machine moves around them, washout occurs as the patient moves, frequently obliterating the image. While this can occur with DMX, its extremely low radiation, reverse contrast design, and collimation methods make such instances very rare and limited. DMX continues to lead in instability studies. Although the software and image-capturing devices may evolve over time, the core principle remains consistent with other radiation-based diagnostic imaging methods. X-rays pass through the body, with the absorbed portion creating internal images displayed on a screen. The DMX fluoroscopic screen captures all motion without requiring a refresh rate.
I sought an Independent Medical Examination (IME) provider's review of my DMX, and they asserted that the DMX offers no diagnostic benefit and exposes me to excessive radiation. Is this accurate?
Absolutely not.
This statement likely arises from one of two reasons: either the IME is not as independent as required, or they lack knowledge about what a DMX truly entails. In my encounters with IMEs, I've found that many are well-intentioned but unfamiliar with DMX, often confusing it with video fluoroscopy. I have successfully countered such arguments in litigation settings multiple times. They may hope that patients, providers, or attorneys won't challenge their assertion, but don't be swayed.
Nationwide, DMX has played a pivotal role in securing substantial settlements. In numerous cases, DMX has stood as the sole evidence demonstrating a genuine permanent injury according to AMA guidelines. While insurance companies are aware of this, they may rely on your lack of awareness to avoid scrutiny. Regardless of the IME's credentials, this argument should be straightforward in court, given established precedents across the country. The truth is, DMX is the gold standard for evaluating ligamentous instability, as detailed in the report under the heading "for the doctor."