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Radiology for Motor Vehicle Injuries

X-Rays after a Car Accident

The chiropractic profession has advanced degrees available for anyone who wants to specialize.  We have neurologists, radiologists, pediatricians, internists, sports injury-ists- you name it, we have it.  All of these degrees require 300 hours of class time and passing grades on tests, with a final comprehensive test with which the degree is conferred.  My experience with those who have the advanced degrees is that they are cut above those who don’t have the degrees.  The diplomate degrees are earned by those who are true knowledge seekers who are in sharp contrast to the DC’s who feel that the state board’s 12 hour requirement for continuing education is a real burden that they would like to avoid.  To each his own, I say, because when I got out of school, I was one of the latter, as I had no time or inclination to go to more school.  But as time goes on, we all change, and five years ago, when I got my digital motion x-ray machine, I soon realized how woefully inadequate my training in personal injury was to that point.  I was being asked questions I couldn’t answer, and that stimulated me to start attending seminars taught by guys like Malik Slosberg, Larry Nordhoff, and Art Croft, all of whom are masters of the medical literature, which made me start to read the literature, and expand my education.  The outcome of all that has been the organizing of all the accumulated information into a continuing education seminar of my own, which is constantly changing as I read new stuff.  But that’s not really the point of this article.The real point of this article is that I just attended a great seminar this weekend, the fourth in the series put on by Dr. Gallagher’s American Academy of Motor Vehicle Injuries, one that taught me some new things, but also made me wish that everyone I know had been there.  It was entitled “Radiology for Motor Vehicle Collisions,” taught by medical radiologists from Elite Rad, a Florida based group of radiologists who really get personal injury.  They are headed up by Sean Mahan, MD, who along with Jay Cavanagh, MD, and Avery Knapp, MD, presented the seminar.   The seminar was sponsored by SimonMed, with whom I have had a confusing relationship over the past five years.  I haven’t found them to be particularly cooperative when it comes to doing custom MRI’s, nor have I found their neuroradiologists to be particularly competent when it comes to reading for ligament damage in the upper cervical spine.   And this has been a real problem for me, as one of the major obstacles I have had since I got into digital motion radiology has been the need for medical validation of my findings.  I’m not a board certified radiologist, though I have found my niche and have become reasonably well educated and conversant in the literature regarding motion x-ray, but in the minds of attorneys and the lay public who make up juries, any ol’ medical radiologist is better than me, even when they have absolutely no training in human biomechanics and x-rays that won’t sit still.   I was aware that for some time now SimonMed has been attempting to position themselves as the “go to” diagnostic facility for personal injury in our area, and admittedly was skeptical of their ability to do so, but I really didn’t understand what they were doing.Now I get it.  Elite Rad ( is a business separate from SimonMed, based in Florida, which has contracted with SimonMed to do diagnostic readings for personal injury cases.  All of the radiologists have been trained by Dr. Mahan, so they all read the same way, or they get yelled at.  They convinced me this weekend that they understand alar/accessory ligament tears, transverse ligament tears, anterolisthesis/retrolisthesis, and  interspinous ligament tears, and will write reports which will tell the truth and attest to the true state of our patients’ injuries.  Let’s face it:  not all radiologists are created equal.  If you put thirty radiologists at random in a room, I guarantee you that there are one or two who are head and shoulders above the crowd.  The radiologists at Elite Rad specialize in reading musculoskeletal studies, and when you do that all day long, every day, you get darn good at it.  One of the advantages SimonMed has had all along is that they are the only diagnostic facility locally which is willing to work on an attorney’s lien in a personal injury case, so when you refer to SimonMed, you specify that you want an Elite Rad radiologist to read the study.  In our age of the internet and teleradiology, it really doesn’t matter where geographically the radiologist is when the study is read.So this is what you do.  Get the latest prescription form for diagnostic studies from your SimonMed representative.  If you are ordering the MRI because I just did a digital motion x-ray on your patient and recommended that you follow up with the MRI, indicate on the form that you want the alar ligament protocol followed.  Write a short letter indicating the medical necessity for the study, and also include pertinent history information which will help guide the radiologists as to where to look.  When you fill it out, indicate on the form that the patient is a personal injury patient, and request that one of the Elite Rad radiologists read the study.  The Elite Rad radiologists are:Sean Mahan, MD; Avery Knapp, MD; Jay Kavanagh, MD; Andrew Akerman, MD; Jonathon Eugenio, MD; Robert Hardage, MD; and Valerie Eckard, MD.Drs. Knapp and Kavanagh are also licensed in Arizona, which is a medicolegal plus, and in addition to reading all standard plain films and MRI’s,  I gathered that they are reading the newest, most specialized studies, including MRI-DTI and MRI-SWI, both of which have applications for our concussed patients.If you have ordered an MRI from a different MRI facility, and gotten an inadequate report, Elite Rad will also over-read and give you a second opinion.   Elite Rad is willing to stand behind their work, and will make themselves available for depositions, arbitrations, and court hearings, whether by video testimony or in-person testimony.  Attorneys should contact Elite Rad Radiology Services  (5840 Red Bug Lake Road, Suite 185, Winter Springs, FL  32708; 1-407-699-1100) for details.
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