Diagnostic Techniques

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CCI and DMX: Can You Still Have Instability with a Normal DMX? What Is a False Negative?

You can’t beat movement-based imaging for finding Cervical Instability. However, all imaging has a false-negative rate. Let’s discuss that and learn about instability in the process. Let’s dig in. What Is Instability? If you had to choose a single concept of what goes wrong in the spine as the most important thing you should know,…read more

What Is a Proper Diagnostic Block Headache Work-up?

There are so many structures in the neck and head that can cause headaches that it’s almost tough to find them all and put them on a big list. However, after having many patients with chronic headaches come into the office and claim that after a simple Occipital Nerve Block that they have had a…read more

Headaches, Blind Men, and an Elephant

Headaches are one of the most confusing problems for patients searching for solutions. Like the elephant and the blind men in the famous parable, each medical specialty seems to have a completely different way of conceptualizing this problem. Let’s dig in. Blind Men and an Elephant This is the parable from Wikipedia: “The parable of…read more

What Does a Proper Low Back Exam Look Like?

Have you ever had the experience of taking your car into a mechanic time and time again, each time something is replaced, and each time your car ends up having the same issues? We would all say that this phenomenon happens because the mechanic didn’t know what was wrong from the outset. This also happens…read more

Ultrasound of the Living Spinal Cord

This morning I would like to share a video of an ultrasound of the Spinal Cord. I happened on this unique view last year and I finally asked my assistant to save a video clip. Let’s dig in. What Is the Spinal Cord? The Spinal Cord is often thought of as the main bundle of…read more

Using Upright Cervical MRI to Diagnose CCI

Neck MRI is often an art and there are units that allow the patient to be imaged while sitting or standing. Today we’ll get into why these units can be very helpful and how that impacts the diagnosis of Craniocervical Instability or CCI. Let’s dig in. What Is CCI? CCI stands for Craniocervical Instability. That…read more

New Craniocervical Instability Book!

Craniocervical Instability or CCI is one one the most confusing topics in medicine to research online. Why? There are only a few pockets of information that all appear to be diametrically opposed to each other. Hence, like I’ve done a few times now, I wrote a book to try and get good information all in…read more

Listening as a Diagnostic Tool in Medicine

Sir William Osler is the physician identified with creating much of our modern medical education system of internship and residency. He would often tell his students something like what I have written above. The goal was to get them to understand that even back at the turn of the 20th century, listening to the patient…read more
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