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.
Digital 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 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.
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 in conjunction 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.
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 (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.
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.
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.
Infrared Electronic Thermography (FLIR-forward looking Infrared)
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.