Dynamic Motion XRay Imaging (DMX)
Can Dynamic Motion XRay Imaging (DMX) help diagnose Craniocervical Instability?
Dynamic Motion XRay Imaging (DMX) of the cervical spine and craniocervical junction is a dynamic motion x-ray using video fluoroscopy may help establish the diagnosis of craniocervical instability (CCI). However, due to low quality and proprietary DMX software, DMX only plays a role in an initial investigation that guides further evaluation.
There has been only one study completed on the Diagnostic Accuracy of Video-fluoroscopy for Symptomatic Cervical Spine Injury Following Whiplash Trauma which concluded “Video-fluoroscopic examination of the cervical spine provides a high degree of diagnostic accuracy for the identification of vertebral instability in patients with chronic pain stemming from whiplash trauma”.
However, it is important to note that DMX reports are not recognized by the majority if not all healthcare systems and physicians, because they are unable to validate the DMX report findings on universal medical system imaging format known as DICOM.
How does Dynamic Motion XRay Imaging (DMX) work?
The patient is put through various movements including the bending of the neck forwards( flexion), bending the neck backwards (extension) and right and left lateral tilt (ear towards left and right shoulders). During dynamic movement a video look is recorded.
Where can I get a Dynamic Motion XRay Imaging (DMX)?
DMX is mostly found in Chiropractic Clinics but also some medical diagnostic imaging clinics. You can do a local internet search to see if you have one nearby.
Another type of DMX that is produced by Konica Minolta Healthcare, is called Dynamic Digital Radiography (DDR). It is newly available and completed by Orthopaedic physicians and Radiologists.
What are the disadvantages of the Dynamic Motion XRay Imaging (DMX)?
The disadvantages of the DMX include lack of medical doctors taking DMX reports seriously, lack of DICOM imaging for a Radiologist/Surgeon to provide a 2nd opinion with craniocervical junction measurements (i.e. only a description of what is visualized can be reported), the inability to assess lax or torn ligaments directly, and significant overlap of bony structures making it low quality imaging and difficult to assess accurately.
As mentioned above, DMX plays a role in an initial investigation that guides further evaluation such as dynamic uMRI, MR angiogram/venogram, Dynamic CBCT/CT etc.