Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 931
Narratives 67N

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: many of these issues are small, yet each issue is just that… an issue. If you take care of the small issues, then the larger issues often take care of themselves and you can focus on the larger issues… a larger, more profitable practice and more family time.

“Demonstrative Evidence: Normal vs. Abnormal”

Show & Tell

“Integrity is ALWAYS being honest, even when it hurts” Mark Studin 2018

We haven’t discussed demonstrative evidence over the past few months and in reviewing my notes on the testifying course, one of the conversations with the attorney was to use comparative graphics. His feelings (and I concur) is to use the patient’s own adjacent tissue structures to make a point of normal versus abnormal. This is so common sense and basic that it is brilliant in design. It is also so brilliant, that I realized how stupid I was in not seeing this before and sharing it with you.

As examples:

1. Herniation at C4-5: on this actual image highlight the normal posterior border of the spine at C3 – 4 and C5 – 6, which then comparatively shows the herniation at C4-5 being abnormal for that patient.

2. Modic 1 change on the inferior endplate of C5: on the actual image highlight the inferior endplate’s of C-4 and C-6, which will then show the bone edema signifying a recent injury at C5 for that patient.

The above two examples show bodily injury for that patient, and utilizing the patient’s own normal structures show that the injury is present. According to the attorney in the testifying course when questioning jurors after a case, this scenario seemed to resonate most true because you’re looking at the person’s own comparative tissue structures and leaves no margin for a counter argument by the opposing side.

When sitting with the plaintiff’s attorney and you have images or any other studies, make sure that you either have created arrows in circles with a computer program on the ACTUAL images (this is better) or simply circled them with a marker (a much poorer choice). The goal as always, is to educate, educate, educate. The more the lawyer knows and the more you are the teacher will add to the lawyer’s faith, confidence and belief in you as the “most important expert” in their practice. In addition, knowing that technology matters greatly… so SUCK IT UP and LEARN…TAKE courses, ask a 10-year old kid to teach you…Whatever it takes!!!

Demonstrative Evidence is one of the most important tools you have to gain their confidence and give them the best opportunity to prevail in their cases.


Adjunct Associate Professor of Chiropractic, University of Bridgeport, College of Chiropractic
Adjunct Post Graduate Faculty, Cleveland University-Kansas City, College of Chiropractic
Adjunct Professor, Division of Clinical Sciences, Texas Chiropractic College
Graduate Medical Educational Presenter, Accreditation Council for Continuing Medical Education Joint Partnership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences 

Academy of Chiropractic
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