"Reporting Imaging Findings when you disagree with the Radiologist"

Quickie Consult 1221
Clinical Information 269 CI

From the Desk of Dr. Mark Studin
Academy of Chiropractic

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time. -Mark Studin 2006

"Age Dating Herniated Discs"


Dr. Studin: I'm all with Dr Jim Grabow from New Jersey and here's the issue. The issue is working with an attorney, you have two sets of images, one from 2016 and one from 2017. Um, and there's really no significant issue other than the radiologist reported an annular tear. Is that correct?

Guest: Well, he also reported a herniation, a L405 on the 2016

Dr. Studin: Okay. But let's just talk about the tear.

Guest: Yeah. The annular tear is what the attorney wants to talk about.

Dr. Studin: Okay. So, the attorney wants you to certify annular fair?

Guest: Yup. Right.

Dr. Studin: Okay, based upon your credentials, because you could be an expert to get them in right now. Did the radiologist report annular fissure? It is called annular fissure. Does the radiologist report it in their report? Yes or no?

Guest: Yes, they did.

Dr. Studin: Okay. And you and I just finished reviewing those images, correct?

Guest: Correct.

Dr. Studin: And you and I can't see a darn thing.

Guest: I can't. I can't see it at all.

Dr. Studin: and we lightened it up. We turned it sideways, we turned it upside down. We darken it. We don't see anything. Right?

Guest: Correct.

Dr. Studin: Here's how I would handle this attorney. I would handle the attorney by saying that I will comment in my report that radiologist, John Smith, whoever it is reported in annual fissure. That's all you'll report. You're not going to approve or agree your district. You're just going to report it that that's what the radiologist found. However, if you're ever on the witness stand that as do you see an annual fissure? I'm going to say no.

Guest: Gotcha.

Dr. Studin: If you want to report for me that simply says in record review, the radiologist reported this. I will do that because that's factual, but I won't put my opinion on it stating that I see an annual efficient. But tell them, I'm just telling you right up front, I don't see it. So, if you put me on the witness stand, I'm going to say I don't see it. But in my report, I'll report on records what they were viewed and this way you have your integrity. The attorney could do with what they choose to do with this, and you're done. And I think that's honest, ethical and it makes sense.

Guest: Okay, that sounds good. Thanks, Mark.

Dr. Studin: All right, thank you. Have fun. 

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