Imaging and records: X-ray, CT, MRI — and your right to the files

Three studies, three jobs

Diagnostic imaging narrows the causes of an injury and confirms the diagnosis. The three main studies divide the work, per the American Academy of Orthopaedic Surgeons:

• X-ray — the most common and widely available study, usually done first. It shows bone well: fractures, alignment, and joint spaces.
• CT — combines X-rays with computer processing into detailed cross-sectional images, for structures that need a closer look or severe trauma to the head, spine, chest, abdomen, or pelvis.
• MRI — works without radiation, using magnetic fields to image soft tissue in high resolution: muscles, tendons, ligaments, and discs.

What imaging shows in a soft-tissue file

Imaging in a whiplash file has a specific job: ruling out what is not a strain. The Quebec Task Force's WAD grades are clinical — set by symptoms and exam findings — which means an unremarkable X-ray or MRI does not mean no injury. A normal study rules out fracture and gross structural damage; it does not measure pain, stiffness, or the muscle spasm the exam finds.

Your right to the records

California's Patient Access to Health Records Act gives patients the right to inspect and obtain copies of their medical records (Health and Safety Code §123100 et seq.). Providers may charge reasonable costs for copying. The practical rule for a claim file: request the records and the images, keep them organized by date, and treat the disc or file of imaging as part of the record — the documentation file explains where they sit in the four-part structure.