A Little Bit About DMX, Digital Motion X-Rays

In this article I want to talk a little bit about Digital motion x-rays or DMX. There’s a lot of information out in the market regarding DMX, most of it coming from the providers who have DMX units in their practices.

So, let’s talk about what DMX is.

First, DMX is not a primary imaging tool, it is a secondary imaging tool.
It is a tool that is usually used by chiropractors and is often used only in the neck. This is because the output of a DMX machine is not strong enough to image the lumbar spine region. This means that DMX can’t really do anything for a patient suffering from chronic low back pain. And as we continually reference, the number one cause of chronic pain and disability in the world today are ligament injuries to the lumbar spine.
Since these injuries cannot be assessed by a DMX machine, DMX does nothing for the majority of patients in today’s injury market. The DMX is limited to being a cervical tool.

To my knowledge there’s only around 200 DMX units in the United States.

Even with this low relative number of machines the providers who use them can be quite vocal about their efficacy. I read and hear them talk a lot about the fact that they’re so much better or more significant than regular x-ray.

I must take issue with this unwarranted criticism of x-ray.

X-ray is the number one primary imaging tool in America for ligament injuries. It is by far the best primary imaging tool in the country. When used properly, it picks up better than 95% of what a DMX will be able to pick up.

I don’t really have an issue with the idea of DMX itself. My only real problem is the providers that use it run down x-ray and that to me is unfair. X-ray is cost effective and uses a far lower dose of radiation You cannot get key information about ligament assessment right away with the DMX. With x-ray you don’t have to wait. It’s not a secondary imaging tool. It’s a primary tool and most findings that you will see on a DMX are found on general digital x-rays.

I don’t care if you use DMX. DMX is what it is. If you want to expand the science of DMX, I have no problem with that. Just don’t run down digital x-rays, because they are highly effective and everyone in the country has access to them.

What you’re going to find on the DMX you’re going to find in a general x-ray study.

X-ray is the best tool in America for ligament assessments. So, SmartInjuryDoctors® know that with basic ligament testing, basic x-ray, and a really accurate intersegmental motion study, you’re going to pick up the majority of severe ligament damage and injuries that most patients in the injury market are suffering.

That’s why I’m a huge proponent of x-ray. I’m not antagonistic or against DMX by any means. Again, I’m only against providers who use DMX as an excuse to run down regular digital x-ray and say that somehow these x-rays are so deficient. They also tend to say that one of the things that comes up in DMX is that there’s bad movement patterns that occur mid-movement. This is something that tends to sell a lot of DMX units.

I met a doctor who’s been doing ligament testing for a long time. Probably more years than anyone else currently active in the injury market today. He’s done more studies than anyone and I’m going to tell you that that I’ve never seen these phenomena of mid-motion translation patterns that do not show up on end range motion.

This is a common thing that DMX providers like to talk about. They openly will say that they’ve done hundreds or that they’ve seen thousands of these things. Yet when I’m in the market, I’ve asked for some examples, show me 10 or 20 of them out of these hundreds or thousands that are out there, and I never get any help finding them.

So, we’ve simply not seen it. In fact, I’ve ran a national spinal ligament testing company for a lot of years and I’ve never seen it in a DMX study. Ever. It can’t be common, that’s all I’m saying.

What I’d like you to understand is that digital x-rays are by far superior in my experience.

All digital x-rays are in a format called DICOM. It’s an easy to use format and virtually every radiologist in the world is familiar with it and can read these x-rays.
DMX on the other hand is not in standard DICOM format.

It’s not in that format at all. This makes it difficult for radiologists to read these images. They are not used to reading digital motion x-rays, but they’re very used to reading x-rays. This makes x-ray a far more accessible tool than DMX in my experience.

With x-rays being a DICOM images, they’re much more accurate to measure. You can calibrate a DICOM image and make incredibly accurate measurements from them. With DMX, this is not the case. It’s possible to make accurate measurements from a DMX image, just extremely difficult and rare.

Now the thing I want you to walk away with today is that SmartInjuryDoctors® know they can use good x-ray studies to do 99% of all ligament injury assessments. This is not the standard in today’s injury market. Too few doctors are able to do a standard spinal instability work-up.

Sometimes we do need a secondary image.

Secondary imaging procedures that I like best are the MRI.

If you are not picking up an injury on a standard x-ray then to me, the next logical step is an MRI. If you’re a DMX user who has a really good understanding of DMX and you’ve already tested everything with a standard x-ray, you may have success using DMX to find what was missing.

I’m all for this type of use of a DMX image, to supplement standard x-rays, not replace them.

But don’t tell someone like me, who’s been doing x-ray studies successfully for years that the x-ray is deficient and missing so much. That’s what I don’t like about the trend around DMX. It tends to run down x-rays and experts in the field who’ve been using x-rays to make credible, accurate ligament injury diagnoses for years. These doctors get incredible results for their patients and should not be run down this way.

It’s not fair and it’s not right.

I’ve written other articles and talked on my podcast about ICA best practices for x-ray. The standard digital x-ray is still the number one primary imaging tool available for ligament injury assessments. We do not need other modalities like MRI, DMX, and CT being used to run down the x-ray when the x-ray has so much data in it.

We just need doctors who can mine the data in x-rays properly and then clinically correlate it.

The standard digital x-ray is readily accessible, inexpensive, and uses far less radiation. DMX subjects the patient to far more radiation than a general x-ray series does. I hope this was helpful to clarify the proper use of DMX and the role that standard x-rays serve as the best primary imaging tool we have as doctors working in the injury market today.