Types of Diagnostic Testing Used for PA Workers’ Compensation Spinal Injuries

When an injured worker in Pennsylvania hurts his or her spine, there are many diagnostic tests that a doctor may prescribe.  Sometimes, the doctors do not fully explain what a test is, or what it may show.  We believe that an injured worker should be fully informed, whether as to the legal aspects of his or her case, or the medical aspects.  While we are certainly not doctors, and would never suggest or recommend treatment, if the doctor will not educate his or her patient, that responsibility can fall to us.  We believe our clients are best served by being fully informed about what is happening in their case, both medically and legally.

From our experience, the first thing a doctor does when seeing a patient for a work injury to the neck or back is get x-rays.  An x-ray will show bone, such as a fracture (including, potentially, a stress fracture), but will not visualize soft tissue, like discs, muscles, tendons or ligaments.  This would be to rule out the presence of a fracture (though, if a fracture is still suspected, a bone scan can be done to better analyze the presence or absence of a fracture).

If the injured worker has pain, numbness or tingling into one or both arms, or one or both legs, a doctor may suspect the presence of “radiculopathy” or “radiculitis”, meaning that a nerve is possibly being pinched or touched by another structure, either a bulging or herniated disc, or due to “stenosis,” a narrowing of the spine which can be degenerative (though stenosis can be “aggravated” by an injury at work).  To assess the discs, and degree of stenosis, doctors often prescribe an MRI, with or without contrast.  The results of the MRI may help the doctor determine whether surgery can help reduce the pressure on the nerve, to potentially relieve the radiating symptoms to the arm or leg.

An MRI is a good tool for visualizing the anatomic status of discs (along with tendons, ligaments and nerves), but an MRI cannot provide assistance with determining how a nerve is functioning.  To assess how a nerve is functioning (whether a nerve is being pinched or irritated), a doctor may prescribe an EMG.  This test can evaluate whether a radiculopathy or radiculitis is present, at what disc level the problem resides, and whether the damage is “acute” or “chronic.”  When combined with an MRI, the EMG can provide helpful insight into whether spinal surgery could help resolve the work injury.

These tests are certainly not the only diagnostic studies available for spinal injuries.  Sometimes CT scans, myelograms, discograms or “EOS imaging” may be used.  The latter of these, EOS imaging, is a new type of diagnostic testing, which, currently, is only available at The Penn Spine Center.  According to The Penn Spine Center:

“This advanced imaging system allows doctors to see a complete view of the spine, from top to bottom in 3-D. The Penn Spine Center is the only center in the region with this type of detailed, advanced imaging system. EOS uses less radiation than a CT scan or conventional radiography.”