In part one of our discussion of diagnostic tests, we discussed three common imaging tests – X-rays, MRIs, and CT scans. Before we continue discussing other tests, let’s take a look at the parts of the body that are examined – that may need to be diagnosed:
The initial medical review
Normally, the ER doctor or treating doctor will conduct an oral examination to review what happened to you while you were working to understand why your injuries happened. The physician will question you about the types of pain you’re experiencing and where your pain is.
The physician will also conduct a physical examination which will include such things as testing your blood pressure, temperature, and pulse. The doctor will examine your lungs with a stethoscope. Depending on your oral answers, the doctor will focus on the parts of the body that are causing you difficulty. He/she may test your range of motion, feel the injured areas, and conduct other physical tests.
If your back or neck are injured the physician will look for signs of spinal cord damage, whiplash, and soft tissue injuries. If your head is injured, including if you have a concussion, then a neurological examination can help look for what is causing your trauma and whether you have any cognitive impairments.’
If the initial exams indicate damage to your spleen, kidneys, liver, or other internal organs; the physician will be concerned that your injuries may be life-threatening. CT scans are often used to help diagnose internal organ injuries.
Many work injury victims have soft tissue issues which are diagnosed by X-rays, MRIs, and ultrasound.
Your physician should also review whether you are having any emotional difficulties or post-traumatic stress disorders.
Your ER doctor or any other treating physician may also order the following tests on behalf of North Carolina or Virginia employees who are injured while working or who suffer an occupational illness:
The Mayo Clinic explains that diagnostic ultrasound (also known as sonography) is an imaging method that uses sound waves to produce images of parts of the inside of your body. These images can help verify what injuries you have and what treatments should be recommended. Normally, the ultrasound device is on the outside of your body – but sometimes a small device is placed inside your body.
Ultrasound may be used for workers’ compensation victims who are injured or who become ill – to evaluate the flow of blood, for biopsy or tumor treatments, to assess joint inflammation (synovitis), and for other reasons. The Mayo Clinic states that there are no known risks.
There are some limits to the use of ultrasound because sound waves don’t travel well through bone or air. Normally, you don’t have to prepare for an ultrasound. Some exceptions may apply. You’ll be advised to wear loose clothing and remove any jewelry.
During the procedure, a gel is applied to your skin – over the part of the body being tested to prevent air pockets which can block sound waves. A technician:
“presses a small, hand-held device (transducer) against the area being studied and moves it as needed to capture the images. The transducer sends sound waves into your body, collects the ones that bounce back and sends them to a computer, which creates the images.”
A radiologist will analyze the images and then file a report with your physician.
Electromyography (EMG)/Nerve Conduction Study (NCS)
The EMG is a diagnostic test to determine “the health of muscles and the nerve cells that control them (motor neurons).” The test can disclose “nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission.” In many injury cases, particularly where the patient is complaining of tingling or numbness in the hands, arms, legs, hands, or feet, it is often performed along with a Nerve Conduction Study (NCS), which is a test that evaluates the function of your peripheral nerves.
Your physician may order an EMG and/or NCS if you have muscle weakness, muscle pain, some types of limb pain, muscle cramping, numbness, or tingling. EMGs and NCS tests are also used to diagnose (or rule out) certain conditions such as certain muscle and nerve diseases and disorders including muscular dystrophy, peripheral nerve disorders, carpal tunnel syndrome, myasthenia gravis, ALS, polio, radiculopathy, and herniated disks.
In an EMG, motor neurons send electrical signals that cause muscles to contract. The test used electrodes to “translate these signals into graphs, sounds or numerical values that are then interpreted by a specialist.” If a needle EMG is required, a needle electrode is inserted directly into a muscle. The NCS portion occurs when “electrode stickers [are] applied to the skin (surface electrodes) to measure the speed and strength of signals traveling between two or more points.”
An EMG/NCS is generally considered to be low-risk. Possible complications can include infections, bleeding, and nerve injury – where a needle electrode is inserted.
The technician or your doctor should explain which prescribed or over-the-counter (OTC) medications you might need to stop taking before the test. You should take a bath or shower before the test to remove oils from the skin – and you shouldn’t apply creams or lotions before the test.
You’ll change into a hospital gown and lie down on an exam table. The technician or neurologist will place electrodes at various spots on your skin or other sites depending on your symptoms. During the EMG, “the surface electrodes will at times transmit a tiny electrical current that you may feel as a twinge or spasm.”
The needle electrode may cause discomfort or pain that usually ends shortly after the needle is removed. You may be asked to change positions during this diagnostic test.
Once the exam is finished, you may have some minor bruises (they should clear up in a few days) where the electrodes were placed.
A neurologist will interpret the results and report to the doctor who ordered the test.
We’ll discuss blood tests, vestibular testing, and autonomic nervous system tests – along with tests for specific body parts – in part three of our discussion.
At Joe Miller Law Ltd., our North Carolina and Virginia workers’ compensation lawyer will guide you through each step of the claims process. These steps include showing that you are eligible and that the employer’s insurance company should pay your medical bills for as long as medical care helps improve your health and keeps your health stable. We work with your doctors to understand what injuries or illnesses you have, what treatments you need, and when and if you can return to work. The diagnostic tests are often critical to confirming your medical disorders and the care you will need.
To discuss your workers’ compensation rights, call attorney Joe Miller, Esq. at 888-667-8295 or fill out my online contact form to schedule a free consultation.
Our law firm does have a way for you to provide your details of your accident and injuries if you simply want to do that electronically from the comfort and safety of your home at any time of day or night. To utilize this service, simply click here: New Electronic Case Review.
We’ll get back to you, typically within 24 hours to provide our response as to whether your situation is one where we can provide you with legal representation. If we require more information, we’ll contact you and ask for that information in order to make that determination as to whether we are the best folks to assist you. If we ultimately determine that we cannot represent or assist you, we will not leave you high and dry. We’ll do our best to provide you with other resources to assist you.