The Doctor
Dr. Thomas Caputo, D.C, CPN, FSBT(c), FPSC(c)
Doctor of Chiropractic
I decided that I wanted to be a chiropractor after I injured my lower back; it was a nightmare! Medical treatments and physical therapy failed and my doctor told me that my only hope might be surgery. As a last resort, I went to a chiropractor and I could feel the difference after only one visit! With regular adjustments, he restored my lower back to normal.
I had also always suffered from asthma and for 15 years, I had taken medications. After my chiropractic visits, I had my asthma under control! Many people think that a chiropractor is only for people who have injured their backs, but if you visit the Conditions portion of our website, you will see that by restoring the nervous system's ability to heal the body naturally, chiropractic can help a variety of conditions.
Once I decided to become a chiropractor, I had to find a college. I finally decided on Life University in Marietta, GA - even though it was a long way from my hometown in New Jersey. I graduated from Life University in 1986 and I have now worked in chiropractic for over 30 years! In the early years of my practice, I was featured in the Book of Who's Who for Young Businessmen.
I now have in my life my beautiful wife, Donna. We enjoy power walks and jogs at the park and boating at the lake with our dogs. I also have three grown children Alyssa, Tommy and Christopher. I have enjoyed coaching sports teams for all three of my children in the past years. I am currently enjoying taking an active part in sharing Tommy's success in crossfit competitions. Teaching mixed martial arts and grappling plus training for triathlons are also personal interests of mine.
SELECTED OCCUPATIONAL HISTORY
Clinic Director/Practicing Chiropractor, Caputo Chiropractic, Suwanee, Georgia, 1988 – Present
EDUCATION AND LICENSURE
Doctor of Chiropractic, Licensed in the State of Georgia, License # 2696, 1988 – Present
Doctor of Chiropractic Licensed in the State of New Jersey, License # 3435, 1987 – Present
Doctorate of Chiropractic, Life Chiropractic College, Marietta, Georgia, 1986
Internship, Life Chiropractic Clinic, Marietta, Georgia, 1985 – 1986
National Board of Chiropractic Examiners, Physiotherapy, 1987
National Board of Chiropractic Examiners, Part II, 1987
National Board of Chiropractic Examiners, Part I, 1987
Undergraduate Studies in Pre Chiropractic, Bergen, Paramus, New Jersey, 1981
CERTIFICATIONS, QUALIFICATION, DIPLOMATES, AND FELLOWSHIPS
Fellowship Candidate in Spinal Biomechanics and Trauma.
Fellowship Candidate in Primary Spine Care.
National Certification in Spinal Decompression from National University - May, 2018
National Certification in Spinal Decompression from Parker University - November, 2018
Master Certification in Peripheral Neuropathy - May ,2019
National Certification in Electroanalgesic Medicine - February, 2019
National Certification in Spinal Decompression from Life University - November, 2021
Advanced Training in Class IV Laser Therapy - January, 2024
Advanced Imaging Certification – MRI Mastery Series, National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Interpretation Review Qualified, Recognized by Cleveland University-Kansas City, Chiropractic and Health Sciences with courses recognized by the ACCGME in conjunction with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences. Qualification language approved by the American Chiropractic College of Radiology (ACCR) and the American Chiropractic Board of Radiology (ACBR), 2021
Active Trauma Team Member -Academy of Chiropractic, 2019 – Present
Primary Spine Care Qualified, This qualification includes graduate chiropractic education in healthy and traumatically altered spinal morphology inclusive of osseous, connective tissue and neurological structure, function and pathology. This certifies you are qualified in assessing predictive models in spinal biomechanics and devising engineering paradigms for treatment plans to maximize spinal Homeostasis in an evidenced based conclusion. In addition, this qualification acknowledges your expertise in triaging the injured and coordinating collaborative care from the trauma through conclusion of rehabilitation. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, College of Chiropractic, Long Island, NY, 2017
Certification in Coding and Documentation 204. University of Bridgeport Chiropractic College, Bridgeport, CT, 2019
Certification in Nutrition: Cardiovascular Disease Risk and Management. University of Bridgeport Chiropractic College, Bridgeport, CT, 2019
Certification in GA Chiropractic Board of Rules. University of Bridgeport Chiropractic College, Bridgeport, CT, 2019
Certification in Legal Do’s and Don’ts of Chiropractic Care. University of Bridgeport, Bridgeport, CT, 2019
U.S. Department of Transportation Certified Medical Examiner, Federal Guidelines and Regulations from the Department of Transportation Federal Motor Carrier Safety Administration for Commercial Drivers National Registration. National Registration of Certified Medical Examiners, New York Chiropractic College and Association of New Jersey Chiropractors, New Jersey, 2014
SELECTED POST-GRADUATE EDUCATION
MRI Mastery Series – Pediatric Imaging - Discussion of advanced MRI techniques for pediatric patients was presented. Focus on optimizing MRI protocols and sequence selection to reduce scan times and improve patient cooperation was detailed. Key sequences include turbo spin-echo (TSE) with proton density (PD) and T2-weighted imaging, and advanced methods like simultaneous multi-slice (SMS) TSE and 3D TSE volumetric SPACE (Sampling Perfection with Application optimized Contrasts using different flip angle Evolution). Emphasis was placed on efficient imaging in children while maintaining diagnostic quality, crucial in musculoskeletal and body imaging. Showcase of techniques like CAIPIRINHA (Controlled Aliasing in Parallel Imaging Results in Higher Acceleration) for faster, high-quality imaging was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Pediatric Imaging - Analysis of growth plate changes in children over a six-month period was discussed. 3D MRI was used to measure the diameter, thickness, and volume of femoral and tibial growth plates in children with growth retardation concerns. The MRI sequences used included sagittal and coronal T1-weighted volume-interpolated breath-hold examination (VIBE) images. Significant increases in the mean diameter and volume of the femoral and tibial growth plates after six months were found, but no significant change in their thickness. This work contributes to understanding growth plate dynamics in pediatric populations. Clinical correlation to real world pediatric MRI cases was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Pediatric Imaging - Discussion of the application of MRI in diagnosing musculoskeletal conditions in children. The analysis of MRI utilization, focusing on the distribution of MRI examinations by sex, age, and body segment was covered. Emphasis is placed on creating an atlas and database for normal pediatric MRI exams across different age groups, as well as imaging findings of various musculoskeletal diseases. The development of specific MRI protocols for different body segments and frequently encountered conditions was encouraged. Details and insights into MRI's role in pediatric musculoskeletal evaluation and serves as a benchmark for future research and resource allocation was provided using real work MRI case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Pediatric Imaging - A comprehensive overview of imaging techniques used in the diagnosis of pediatric musculoskeletal injuries. The critical role of ultrasound (US) and Magnetic Resonance Imaging (MRI) in identifying and characterizing a wide range of injuries was highlighted. Discussion into specific injury types across various body parts, including upper and lower limbs, detailing the utility of different MRI sequences, such as T1-weighted, T2-weighted, and STIR (Short Tau Inversion Recovery), in revealing pertinent details like bone marrow edema and ligament tears. Emphasis was placed on the advantages of MRI, notably its high spatial and contrast resolution, which is crucial in the diagnosis of soft tissue, cartilaginous, and osteochondral injuries. Continued discussion of the importance of MRI in post-traumatic follow-ups, particularly in young athletes, due to its non-ionizing nature was outlined. Overview underscores the indispensable role of advanced imaging in the accurate diagnosis and management of pediatric musculoskeletal injuries. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Pediatric Imaging - Discussion on real-time imaging techniques discussing the development and application of highly under sampled radial gradient echo sequences combined with nonlinear inverse image reconstruction. The advancement allows for rapid image acquisition (20 ms) and high frame rates (up to 50 fps), enabling real-time MRI videos with spin density T1 and T2-type contrast. The use of a 180° inversion pulse for accurate T1 mapping within 4 seconds, offering significant benefits in pediatric radiology by reducing the need for sedation or anesthesia was highlighted. Practical applications include dynamic studies of speech, swallowing, and body movements, as well as rapid volumetric assessments and real-time cardiac MRI without ECG gating, all contributing to enhanced diagnostic capabilities in early childhood. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Pediatric Imaging - Focus on the increasing incidence of meniscal tears in children, emphasizing the importance of accurate diagnosis and treatment was provided. Extensive discussion of MRI's role in detecting meniscal tears, highlighting specific MRI sequences such as sagittal and coronal projections. The uniqueness of pediatric meniscal anatomy and the implications for treatment, underscoring the preference for meniscal repair over partial meniscectomy due to better healing outcomes in children was emphasized. Various tear patterns identifiable through MRI, including longitudinal, horizontal, radial, root, and complex tears, and their respective treatment approaches were outlined and presented. Challenges and intricacies in interpreting pediatric knee MRIs due to the higher vascularity in children's menisci was discussed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Pediatric Imaging - Investigation of a near-silent, distortion-free diffusion-weighted imaging (DW-SD) sequence in pediatric musculoskeletal MRI was presented. This technique was comparted with standard echo-planar diffusion-weighted imaging (DW-EPI), focusing on image quality and apparent diffusion coefficient (ADC) values. Review of the utilization of DW-SD based on a rotating ultrafast sequence modified with sinusoidal diffusion preparation gradients at 3T was outlined and detailed. DW-SD offers similar ADC values, but improved image quality compared to DW-EPI, highlighting its potential for pediatric musculoskeletal imaging. Review and discussion of real-world cases was provided. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Pediatric Imaging - Presentation on developing a fully automated, computer-based method for age estimation using 3D knee MRI was presented. Machine learning, specifically convolutional neural networks (CNNs) and tree-based algorithms, applied to a dataset of coronal and sagittal MR volumes was reviewed. Discussion of the high level of accuracy in age estimation, highlighting the potential of deep learning in medical imaging was provided. Details of the methods, including image pre-processing, bone segmentation, and the machine learning framework used for accurate age assessment were provided. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Knee - A comprehensive overview of MRI techniques for knee imaging, covering both conventional and advanced methods was provided. Emphasis was placed on the role of MRI in diagnosing knee pathology, focusing on meniscal and cruciate ligament tears. Review of various MRI protocols and sequences, including T2-weighted, Proton Density (PD), and Short Tau Inversion Recovery (STIR), highlighting their specific applications in detecting soft tissue and bone injuries was given. Exploration of advances in MRI technology, such as 3D isotropic and ultrashort echo time sequences, offered insights into their clinical implications in knee imaging. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Knee - Examination of Morel-Lavallee lesions, focusing on their pathophysiology, clinical and imaging findings, and management strategies. Emphasis of MRI as the ideal modality for diagnosing and characterizing these lesions, highlighting its superiority in revealing the detailed anatomy and composition of these injuries was detailed. Discussion of MRI sequences such as T1-weighted, T2-weighted, and Short Tau Inversion Recovery (STIR) images was provided, noting their effectiveness in differentiating acute from chronic lesions and in identifying key features like hematomas, fluid collections, and fibrous capsules, crucial for accurate diagnosis and treatment planning. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Knee - Discussion and review of how coronal alignment impacts distal femoral anatomy, focusing on varus and valgus knees was presented. Assessment of the relationship between the epicondylar axis (EA) and the posterior condylar axis (PCA) in relation to coronal deformity was provided. Demonstration of a heterogeneous relationship between PCA and EA, not significantly altered by valgus deformity was presented. Emphasis was placed on the need for careful rotational alignment in total knee arthroplasty to avoid malrotation of the femoral component, particularly in valgus knees. MRI sequences used included T2-weighted imaging, crucial for detailed knee evaluations with correlation to MRI case studies. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Knee - An in-depth analysis of MRI techniques used for evaluating knee cartilage repair was presented. Comparison of the effectiveness of various MRI sequences, including 2D and 3D Fast Spin Echo (FSE) and Gradient Recalled Echo (GRE) sequences, in assessing the morphology and composition of cartilage repair tissues was detailed. Discussion on the use of advanced MRI sequences like Dual-Echo Steady-State (DESS) and Balanced Steady-State Free Precession (bSSFP) for more detailed cartilage evaluation was outlined and reviewed in detail. Information was correlated to real world case examples providing crucial insights for clinical applications in orthopedics and sports medicine. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Knee - Focus was on validating an MRI-based automated method for quantifying knee-extensor muscle volume and hypertrophy. Utilization of a two-point Dixon sequence for fat-water separation, compared automated and manual segmentation of the quadriceps muscle, examining their sensitivity in detecting volume changes due to resistance training. Confirmation of the automated method's strong correlation with manual segmentation and its ability to detect exercise-induced muscle hypertrophy, highlighting its potential application in sports science and clinical settings for accurate muscle mass measurement. MRI sequences included T2-weighted Turbo Spin Echo and T1-weighted gradient echo with a 2-point Dixon reconstruction. Application of this information to real world MRI cases was detailed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Knee - Exploration of the anatomic characteristics of the anterolateral ligament (ALL) in the knee was provided. Detailed review of 53 studies, highlighting the ligament's presence in various populations and detailing its morphological features was given. Emphasis was placed on the effectiveness of MRI, particularly in the coronal plane and using T2-weighted images, in visualizing the ALL anatomy. Demonstration of the ligament’s trajectory, insertions, and dimensions offered valuable insights for clinical applications in orthopedics and sports medicine. Detailed case examples were provided. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Knee - Comprehensive examination of the popliteal hiatus, focusing on its anatomy, magnetic resonance imaging (MRI), and arthroscopic views was presented. Emphasis was placed the complexity of the popliteal hiatus and its significance in knee stability and pathology. Key MRI sequences discussed included sagittal and coronal views, which are crucial for evaluating the popliteal hiatus and associated structures like the popliteomeniscal fascicles and the meniscofibular fascicle. Challenges in diagnosing popliteal hiatus-related pathologies due to the intricate anatomy and the limitations of standard MRI techniques was highlighted using real world case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Knee - Details on the management of a patellar sleeve avulsion fracture in a 12-year-old male athlete previously diagnosed with Sinding-Larsen-Johansson syndrome was presented with a detailed review of imaging sequences. Emphasis on the rarity of such injuries and the challenges in diagnosis, often overlooked in plain radiographs, was given. Key imaging techniques included MRI sequences like T2-weighted MRI, helping in diagnosing and differentiating between Sinding-Larsen-Johansson syndrome and patellar sleeve avulsion. Analysis of surgical intervention involved the use of double transosseous ultra-high strength tapes, with postoperative MRI confirming healing with specific images being reviewed. The importance of early clinical suspicion and the use of specific MRI sequences in managing complex knee injuries in young athletes was discussed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - Discussion of the diagnostic efficacy of MRI and ultrasonography for adhesive capsulitis (frozen shoulder) was presented. Review of the use of fat-suppressed T2-weighted MRI and ultrasonography for detecting capsular thickening, particularly in the rotator cuff interval and axillary recess was detailed. The importance of these imaging techniques in the accurate diagnosis and effective management of adhesive capsulitis, contributing to better patient outcomes was emphasized. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - A detailed and comprehensive review of the shoulder's structural and functional anatomy, focusing on the scapulothoracic mechanism, sternoclavicular, and acromioclavicular joints was provided. Insights into the resting position of the scapula, effects of aging and spinal posture on its position, and detailed analysis of the glenohumeral joint were presented. Emphasis was placed on the interplay of articular, periarticular, and muscular mechanisms in maintaining shoulder stability and concludes with a discussion on the integrated function of the scapulothoracic and glenohumeral articulations in upper extremity elevation. Anatomical structures were reviewed and compared to MRI images and specific clinical case studies. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - Examination of the identification of ligaments attached to the coracoid process using 3T MRI without contrast was presented. Focused on coracohumeral (CHL), coracoclavicular (CCL), coracoacromial (CAL), and cranoglanidid (CGL) ligaments, the employment of Proton Density Fat Saturated (PDFS) and non-fat saturated T1 and T2 sequences was reviewed. Key findings include the identification of these ligaments in various MRI sequences, with a particular emphasis on the sagittal T1 and PDFS sequences for substantial interobserver agreement and better visualization of the CGL ligament. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - Discussion of the efficacy of Magnetic Resonance Arthrography (MRA) in identifying and classifying chronic anteroinferior labrum lesions was provided. Analysis of 80 patients using MRA with 1.5T magnet, using standard spin echo T1-weighted sequences with fat-suppressed images in neutral and abduction external rotation (ABER) positions was outlined. Findings were compared against arthroscopic results to assess the accuracy and reliability of MRA in diagnosing specific labral lesions like Bankart, Perthes, and anterior labrum periosteal sleeve avulsion (ALPSA) lesions. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - Presentation of a detailed exploration of the anatomical distribution and function of sensory nerve branches in the human shoulder joint was given. Emphasis was placed on the critical role of these nerve branches in the perception of shoulder pain, identifying key sensory nerves like the suprascapular, axillary, and lateral pectoral nerves. The complex patterns of innervation and the concentration of nociceptors in specific areas, providing valuable insights for clinical approaches in managing shoulder pain was highlighted. The findings have significant implications for surgical interventions and pain management strategies. Correlation with MRI images and specific case studies was given. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - Exploration of the advancements and applications of three-dimensional (3D) magnetic resonance imaging (MRI) in evaluating shoulder pathologies was presented. Details of the superiority of 3D MRI over traditional two-dimensional (2D) imaging in terms of detail and diagnostic accuracy, particularly in assessing glenoid bone loss and rotator cuff tears were provided. Focus on specific MRI sequences such as the 3D Gradient Echo (GRE) sequence with two-point Dixon water-fat separation and Volumetric Interpolated Breath-hold Examination (VIBE) was provided. Review of sequences enhancing the visualization of osseous and soft tissue structures, proving crucial in preoperative planning and clinical decision-making was presented and correlated to case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - An in-depth analysis of the characteristics, diagnosis, and treatment outcomes of delaminated rotator cuff tears were provided. Emphasis on the use of magnetic resonance (MR) arthrography, particularly indirect MR arthrography, for accurate identification and classification of these tears was presented. Categorization of delaminated tears based on their appearance in MR images, including features like horizontal splitting and the degree of retraction in the bursal and articular layers was discussed in detail. The importance of recognizing these tears preoperatively for tailored surgical repair, highlighting various MRI sequences such as fat-suppressed T2-weighted images for effective diagnosis was highlighted. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - A comprehensive analysis of the cost-effectiveness of various MRI strategies for diagnosing Superior Labrum Anterior and Posterior (SLAP) tears was provided. Utilization of decision analytic models to compare the cost-effectiveness of different MRI protocols, including 1.5-T and 3-T MR arthrography (MRA) and unenhanced MRI, for a hypothetical population of 25-year-olds with a previous diagnosis of SLAP tear was provided. Focus was that unenhanced 3-T MRI is the most cost-effective strategy for suspected SLAP tear patients, and when 3-T imaging is not available, 1.5-T MRA is more cost-effective than 1.5-T MRI. Outline of the higher specificity of these tests, leading to fewer false positives and unnecessary surgeries was given. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - Characterization of the intraarticular anatomy of the long head of the biceps tendon using magnetic resonance (MR) arthrography was presented. Investigation into the correlation between anatomical variants of the intraarticular long head biceps tendon and Superior Labral Anterior to Posterior (SLAP) lesions was presented. Utilization of Fisher's exact test and logistic regression for statistical analysis, the association of specific anatomical variants with the increased risk of developing SLAP lesions was highlighted. Emphasis was placed the importance of MR arthrography in identifying these anatomical variants and their relation to SLAP lesions. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - Review focused on the use of magnetic resonance (MR) arthrography to investigate the relationship between anatomical variants of the long head of the biceps tendon and the occurrence of SLAP lesions. A 1.5-Tesla MR imaging system with a dedicated shoulder array coil, utilizing T1-weighted spin-echo and fat-saturated PD/T2-weighted sequences was discussed. Correlation between certain anatomical variants and the presence of specific types of SLAP lesions, suggesting the influence of biceps tendon variants on shoulder pathology was discussed and correlated to real world case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - Presentation on using T2 mapping at 3-Tesla MRI to assess the glenoid labrum and differentiate between healthy labral substances and SLAP lesions was provided. Review of specific MRI sequences such as Proton Density-weighted fat-saturated sequences (PD fs TSE) and T2-weighted sequences (T2 TSE), with T2 MapIt as the primary study sequence was outlined. Demonstration that T2 mapping could effectively distinguish between normal and damaged labral substances, demonstrating potential for non-invasive diagnosis of SLAP lesions. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - A comprehensive overview of SLAP lesions, covering their etiology, classification, and management was presented. Discussion of the pathophysiology of SLAP lesions, highlighting their occurrence in different populations, including athletes and laborers was provided. Review of diagnostic methods, primarily focusing on MRI and MR arthrography techniques was outlined. Emphasis was placed on the importance of recognizing labral variations and other shoulder pathologies in MRI assessments. Treatment approaches, both non-operative and surgical, were explored in detail, with focus on tailoring management to individual patient needs and lesion types. The presentation emphasized the need for an interprofessional team approach for optimal outcomes. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Shoulder - Analysis of shoulder MR arthrography (MRA) for SLAP lesion detection was presented. Focus was on comparing the diagnostic performance of MRA in neutral, internal rotation (IR), and external rotation (ER) positions. Discussion of higher sensitivity and diagnostic accuracy in the ER position, with ER also showing a significant increase in labral diastasis length. Emphasis was placed on MRA in the ER position enhances SLAP lesion diagnosis, recommending ER and IR scans in standard shoulder MRA protocols. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Hip - Extensive examination of hip labral tears, emphasizing their etiology, clinical presentation, and treatment options was presented. Use of Magnetic Resonance Arthrography (MRA) as the preferred diagnostic tool due to its superior imaging capabilities in identifying labral tears was detailed. Discussion of the use of MRI, though noting its limitations compared to MRA was outlined. Treatment approaches for labral tears, including conservative management and arthroscopic intervention, were detailed, underscoring the importance of tailored treatment strategies based on the severity and nature of the tear. Clinical correlation to symptoms, mechanism of injury and MRI studies was emphasized using real world case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Hip - Focus was on diagnosing and treating sports hernia and athletic pubalgia. Emphasis was placed on the complexity of these conditions, often associated with femoroacetabular impingement (FAI), and details the various imaging modalities used in evaluation. MRI sequences discussed include coronal, oblique, and axial sequences through the rectus insertion and pubic symphysis, in addition to standard sagittal, coronal, and axial sequences. Overview of how these MRI techniques are crucial in identifying the specific pathologies associated with sports hernias and athletic pubalgia, aiding in effective management and treatment planning was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Hip - Evaluation of the role of MRI in diagnosing avascular necrosis (AVN) of the hip was discussed and detailed. Utilizing a 1.5 tesla MRI machine, MRI sequences included T1 and T2 weighted axial, coronal, sagittal, and short-tau inversion recovery (STIR) sequences. Identification of common MRI findings in AVN, such as subchondral signal abnormalities and hip joint effusion, and focused on the staging of AVN using Mitchelles and Ficat and Arlet classifications was presented and discussed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Hip - Detailed outline of optimal imaging approaches for assessing femoroacetabular impingement (FAI) was provided. Specific use of radiography for initial assessment, emphasizing the need for pelvic and hip radiographs was discussed. MRI protocols were reviewed for detailed evaluation of intraarticular hip pathology, including the use of small field-of-view (FOV) imaging with oblique axial and radial sequences. The importance of CT imaging for complex surgical planning and femoral torsion assessment, highlighting the role of multiplanar radiography and MRI in comprehensive FAI diagnosis and management was detailed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Hip - An extensive review of MRI techniques for assessing hip anatomy and pathologies was presented. Discussion of various MRI sequences, such as T1-weighted, T2-weighted, Proton Density (PD), and Short Tau Inversion Recovery (STIR), highlighting their roles in evaluating different aspects of hip anatomy, including bone, cartilage, labrum, ligaments, and surrounding soft tissues was given. Valuable insight into the application of MRI in diagnosing and managing hip disorders, as a significant resource for professionals in musculoskeletal radiology and orthopedics was offered. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Hip - Evaluation of the diagnostic accuracy of 3.0 T MRI and MR Arthrography (MRA) for detecting acetabular labral tears (ALT) was presented. Demonstration that 3.0 T MRI exhibited comparable sensitivity and superior specificity to MRA, indicating its efficacy in diagnosing ALT. Highlight of 3.0 T MRI as a non-invasive, fast, and convenient option, preferable over MRA for detecting suspicious ALT cases in clinical settings was given. Overview emphasized optimizing imaging strategies in diagnosing hip joint pathologies. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neurovascular Imaging - Discussion of the role of brain perivascular spaces (PVS) as biomarkers of vascular risk in a diverse, stroke-free population was outlined. Demonstration of specific brain MRI imaging, particularly FLAIR (Fluid Attenuated Inversion Recovery) and T1-weighted sequences, assessment of the association of small and large PVS with vascular events, including stroke and myocardial infarction was shown. Demonstration that a higher burden of small PVS, especially in conjunction with elevated pulse pressure or systolic blood pressure, increased the risk of vascular events in patients was presented. Emphasis placed on the understanding of PVS as potential indicators of vascular risk with specific case examples was given. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neurovascular Imaging - Investigation of the anatomical characteristics of the petrous ridge and trigeminal nerve in trigeminal neuralgia (TN) patients without neurovascular compression (NVC) was outlined. Utilization of high-resolution three-dimensional T2 MRI sequences demonstrated the angles of the petrous ridge (APR) and trigeminal nerve (ATN) in 66 TN patients and 57 controls. Details showing that APR and ATN were significantly smaller in TN patients, suggesting these anatomical differences could contribute to the etiology of TN without NVC. Discussion provided insight into potential diagnostic markers for TN in the absence of NVC using specific case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neurovascular Imaging - Presentation on the impact of four MRI markers of covert vascular brain injury (VBI) - white matter hyperintensities (WMHs), MRI-defined brain infarcts (BIs), cerebral microbleeds (CMBs), and perivascular spaces (PVSs) - on the risk of stroke, dementia, and death was provided. A comprehensive analysis of these markers through a meta-analysis of 94 prospective studies was given. Emphasis on extensive WMHs, BIs, and CMBs are significant predictors of stroke and death, while extensive WMHs are also linked to an increased risk of dementia. Review of findings underscore the clinical importance of these MRI markers in predicting and managing vascular brain injuries. Details were provided with case study examples and imaging review. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neurovascular Imaging - Presentation of a comprehensive analysis of various MRI methods for diagnosing neurovascular compression (NVC) in patients with trigeminal neuralgia (TN) and hemifacial spasm (HFS) was given. Details included a network meta-analysis comparing the diagnostic efficacy of different MRI techniques: 3D Time-of-Flight Magnetic Resonance Angiography (3D TOF MRA), High Resolution T2-Weighted Imaging (HR T2WI), a combination of 3D TOF MRA and HR T2WI, and 3D Multimodal Image Fusion (MIF) based on 3D TOF MRA and HR T2WI. Analysis that 3D MIF, based on the combination of 3D TOF MRA and HR T2WI, shows superior diagnostic performance in detecting NVC. Real case examples of neurovascular imaging were provided and discussed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neurovascular Imaging - Discussion of Magnetic Particle Imaging (MPI), an emerging biomedical imaging technique was presented. Focus was on the use of superparamagnetic iron oxide nanoparticles (SPIOs) for imaging, offering clear contrasts due to zero signal from background tissues. Exploration of MPI's potential in vascular imaging and cell tracking, highlighting its advantages over traditional methods in terms of sensitivity, contrast, and depth of imaging was provided. Discussion underscored MPI's impact on the medical field, particularly in diagnosing and tracking various diseases was provided. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neurovascular Imaging - An in-depth examination of phase-contrast MRI, a technique that utilizes the phase data inherent in all MRI signals for velocity measurement was presented. Discussion of the basic physics underlying this method, the technical factors involved, and the various clinical applications such as cardiac valvular flow imaging, CSF flow analysis, MR angiography, MR venography, and elastography was given. Overview of the importance of understanding the principles of phase-contrast imaging for accurate image acquisition and interpretation in diagnostic imaging was provided and supported by case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neurovascular Imaging - Focus on a novel anomaly detection method using neural network architecture to identify chronic brain infarcts in MRI images was provided. Highlights of the use of T1-weighted gradient-echo and T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences for brain imaging were provided. Demonstration that this method can detect a significant portion of chronic brain infarcts, including those previously overlooked, thereby enhancing diagnostic accuracy, and potentially improving radiological workflow efficiency was reviewed and emphasized using real world case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neurovascular Imaging - A comprehensive overview of diffusion MRI techniques used to image brain microstructure was presented. Review of various diffusion-weighted MRI measurements and the evolution of computational models that link MRI signals to brain tissue microstructure was outlined. Focus on the practical aspects of implementing and using these techniques in biomedical studies, highlighting their growing transition from research to widespread application was given. Discussion of the design and validation of microstructure imaging techniques and concludes with future perspectives and potential advancements in this field was detailed using MRI case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Anatomy - An in-depth analysis of deep learning techniques for MRI segmentation was presented. Discussion of the use of convolutional neural networks (CNNs) in the segmentation of both normal brain structures and brain lesions was detailed. Emphasis is placed on the importance of image preprocessing, network architecture styles, and training-validation strategies for effective segmentation. Review of the challenges and future directions in deep learning applications for brain MRI segmentation, addressing the need for improved accuracy and efficiency in diagnostic imaging was provided. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Anatomy - Detailed discussion on enhancing deep brain stimulation (DBS) surgical planning through ultra-high field 7T MRI was provided. Comparison of different 7T MRI sequences, such as FGATIR and T2-weighted sequences, assessing their effectiveness in visualizing small subcortical areas, crucial for accurate DBS targeting was provided. Demonstration that FGATIR offers high contrast-to-noise ratio and better fiducial marker detection with fewer artifacts, while T2-weighted sequences provide high image quality with minimal errors in local distortion was given. Overview of research representing a significant advancement in neuronavigation, potentially improving surgical outcomes in functional neurosurgery was given with specific MRI brain study case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Anatomy - Focus on the advanced MRI techniques for cranial nerve imaging. Emphasis was placed on the use of heavily T2-weighted three-dimensional steady-state free precession (SSFP) sequences for high spatial resolution and contrast-enhanced T1-weighted sequences for detailed nerve visualization. Review of congenital, traumatic, and vascular diseases affecting cranial nerves, demonstrating the value of MRI in diagnosing these conditions was detailed. Discussion on the use of computed tomography (CT) scans, particularly with bone window settings, for detecting related pathologies was presented and demonstrated using real world MRI studies and cases. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
Advanced Imaging Certification – MRI Mastery Series – Brain Anatomy -
A comprehensive examination of educational systems for virtual human anatomy, emphasizing the integration of visualization and interaction techniques was presented. Various aspects of anatomy education, including the educational background, datasets like cadaver and clinical image data, visualization techniques such as surface and volume visualization, and knowledge representation and labeling in anatomy education systems was presented. Discussion of the use of stereoscopic and virtual reality systems in anatomy education, evaluating the effectiveness of various virtual anatomy systems with the support of MRI imaging was detailed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Anatomy - Examination of the influence of T1-weighted MRI quality on morphometric brain measures. Utilization of the Computational Anatomy Toolbox (CAT12) for assessing MRI quality and employing the Freesurfer software for brain morphology analysis was outlined. Discussion of the significant correlations between MRI quality and various metrics, including cortical thickness, surface area, and subcortical volumes was presented. The necessity of considering image quality in MRI studies to ensure accurate interpretations, particularly in research involving neurodevelopment and clinical applications was discussed citing specific case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Anatomy - Review of MRI techniques to measure natural brain tissue pulsations. Detailed review of five main MRI methods: Phase-contrast MRI, Complementary Spatial Modulation of Magnetization (CSPAMM), Displacement Encoding with Stimulated Echoes (DENSE), anatomical landmark motion tracking, and amplified MRI (aMRI) was presented. Emphasis on variations in brain tissue displacement across different regions, discussing studies on healthy brains and pathological conditions like tumors, idiopathic intracranial hypertension, and Chiari malformation. Highlights of the potential of MRI to provide insights into brain mechanics and pathophysiology was presented along with specific case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Anatomy - Presentation of the dynamic network organization of the brain. Challenges to the traditional view of localized brain function, proposing a meta-networking model where complex cognitions and behaviors emerge from distributed, specialized networks was presented. Discussion of various neuroimaging techniques, particularly focusing on the use of functional magnetic resonance imaging (fMRI), both task-based and resting-state, to explore these networks. Key techniques include diffusion tensor imaging (DTI) for structural connectivity analysis and voxel-based lesion-symptom mapping, enhancing understanding of brain connectome and its implications in cognitive neuroscience and clinical applications. Specific case examples of alteration of brain function and anatomy were presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Anatomy - A comprehensive historical overview of the development and understanding of cranial nerves. Review of the evolution of knowledge from the early works of Galen, through significant contributions in the Renaissance, to contemporary understanding. Various classification systems and the identification of cranial nerve nuclei was described. Highlights of the significant milestones in the anatomical and physiological understanding of the cranial nerves, reflecting on the influences of technology, such as microscopy, on these advancements were detailed and presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Anatomy - An academic exploration into the complexities and methodologies of segmenting MRI images of the human brain. Focus was on the identification and delineation of brain structures using various MRI sequences and techniques. Key topics include the basic concepts of MRI segmentation, the challenges posed by the brain's intricate anatomy, and the application of advanced computational methods. Elaboration on the importance of preprocessing steps like image registration, bias field correction, and the removal of non-brain tissue. Discussion of the nuances of different MRI sequences such as T1-weighted and T2-weighted images, and how this impact segmentation quality. Emphasis was placed on understanding tissue-specific intensity distributions and the integration of spatial context modeling, highlighting the use of Markov Random Fields and other statistical approaches for enhanced accuracy. Analysis of various MRI segmentation methods and their applications in clinical and research settings was provided with specific examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - Presentation into the impact of meningioma treatment on cognitive functions was given. Highlights of the diversity in cognitive assessment tools and the lack of standardized methods, making the comparison of outcomes challenging were emphasized. The identification of memory, attention, executive functioning, language, and cognitive flexibility as key affected domains was outlined. Emphasis on the need for standardized cognitive assessment tools and longer follow-up periods to better understand and manage cognitive impairment in meningioma patients’ post-treatment. This information was presented alongside specific examples of MRI case studies showcasing the importance of interprofessional assessment. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - Outline of the screening and diagnostic protocols for Endolymphatic Sac Tumors (ELSTs) in von Hippel-Lindau (VHL) disease was presented. Emphasis was placed on the use of MRI, particularly high-resolution (1mm slice thickness) MRI of the internal auditory canal, for baseline screening and diagnosis. Presentation supporting this MRI as crucial in identifying ELSTs, with particular attention to post-contrast T1-weighted imaging for contrast-enhancing lesions in the temporal bone was given. The significance of CT imaging, especially thin-slice imaging of the temporal bone, as a complementary diagnostic tool in equivocal MRI cases was underscored. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - A comprehensive overview of meningiomas, emphasizing their diverse histopathological grades and variable prognosis was given. Highlights of the pivotal role of MRI in diagnosis, particularly T2-weighted (T2W), T2 Fluid-Attenuated Inversion Recovery (FLAIR), and T1-weighted post-contrast (T1W+C) imaging for identifying characteristic features like a dural tail and homogeneous enhancement was detailed and emphasized. Review and discussion of advances in surgical techniques, radiotherapy, and emerging systemic treatments, along with the potential of molecular and genetic profiling in guiding therapy was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - Focus on distinguishing between intracranial hemangiopericytoma and angiomatous meningioma using a CLIN radiomic model based on multiparametric MRI was presented. Review of research involving the selection and analysis of significant radiomic features extracted from T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (CE-T1WI). The presentation of modeling showcasing high accuracy and utility in the preoperative differential diagnosis, contributing to better clinical decision-making and treatment planning was detailed. Key MRI sequences highlighted include T2WI and CE-T1WI were discussed and correlated with real world MRI case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - Exploration of the genetic characteristics and clinical outcomes of rhabdomyosarcoma (RMS), a common childhood soft tissue sarcoma was presented. Identification of genomic markers for risk stratification beyond PAX-FOXO1 fusion status was discussed. Analysis of tumor samples from international cohorts, significant genetic alterations, including mutations in TP53 and MYOD1, which were associated with worse outcomes were identified. Review of findings contributing to the refinement of risk stratification and suggest potential targets for personalized therapies was detailed and correlated to specific MRI imaging sequences with case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - A comprehensive overview of meningiomas, including their epidemiology, etiology, pathology, and treatment options was presented. Discussion of the latest updates in grading, diagnostic imaging techniques, and molecular characteristics of meningiomas was given and detailed. Clinical features, various treatment strategies, and future research directions in the field of meningioma, highlighting the importance of personalized medicine and the potential role of molecular diagnostics and therapies was reviewed in detail with specific MRI cases studies correlated. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - Review of cervical spine hemangiopericytoma/solitary fibrous tumor was presented. The use of magnetic resonance imaging (MRI) for diagnosis, focusing on T2-weighted imaging (T2WI) and T1-weighted imaging (T1WI) to identify the lesion's characteristics was highlighted. Exhibition of a slightly hyperintense signal on T2WI and a low signal on T1WI without enhancement was showcased. The importance of MRI in diagnosing spinal tumors, emphasizing the role of specific imaging sequences in clinical assessment and treatment planning was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - Presentation of the application of radiomics and machine learning (ML) in diagnosing and grading meningiomas using MRI was given. Evaluation of methodological quality and performance of a meta-analysis of relevant studies was discussed. Focus on assessment of the accuracy of ML models in predicting meningioma grading from pre-operative brain MRI images, highlighting the integration of ML with conventional and contrast-enhanced T1-weighted MRI sequences for improved diagnostic performance was outlined. Emphasis was placed on the need for standardization and rigorous methodological quality in future studies for clinical implementation with specific MRI case studies reviewed and correlated. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - Review of primary extracranial meningiomas (PEMs), focusing on their rare occurrence and clinical presentation was presented. Discussion of histopathological features, with emphasis on their benign nature despite occasional aggressive behavior, and the importance of immunohistochemical analysis for accurate diagnosis was given. Advocation for surgical removal as the primary treatment, highlighting the role of neuroimaging and histological investigation in diagnosing these rare tumors was emphasized. Comparison into the differentiation of PEMs from other neoplasms underscoring the generally favorable prognosis of these tumors was detailed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Tumors - Analysis of the interaction between meningiomas and the brain parenchyma was reviewed with imaging correlation to anatomical mapping. The role of microglia/macrophages and astrocytes in meningioma development and the potential for tumor-brain crosstalk through cytokines and chemokines was detailed. The impact of the interaction on meningioma growth and behavior, identifying gaps in current research and suggesting directions for future studies was discussed. The importance of understanding the tumor microenvironment (TME) in meningiomas for developing targeted therapies was underscored with specific MRI case examples provided.
National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Entrapment Neuropathies - Highlights of the diagnostic capability of MRI in cases of Parsonage-Turner Syndrome, a form of immune-mediated brachial plexopathy was presented. Emphasis was on the use of Short Tau Inversion Recovery (STIR) MRI sequences in detecting pathological changes in the brachial plexus with detailed anatomy review. The importance of MRN in conjunction with clinical and electrophysiological assessments for a comprehensive diagnosis, showcasing its effectiveness in identifying nerve root inflammation, aiding in timely and accurate diagnosis, and guiding appropriate therapeutic interventions was detailed and correlated to specific MRI films. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Entrapment Neuropathies - A comprehensive overview of peripheral nerve sheath tumors (PNSTs), discussing their diagnostic and pathologic features was given. A range of PNSTs, including schwannomas, neurofibromas, perineuriomas, and malignant peripheral nerve sheath tumors (MPNSTs), and their genetic and molecular aspects were detailed. Review of the association of these tumors with genetic syndromes like neurofibromatosis and schwannomata was presented. Emphasis was placed on morphological criteria, immunohistochemical profiles, and genetic alterations that are key to the diagnosis and understanding of these tumors. These details were correlated with review of MRI films and images with specific case examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Entrapment Neuropathies - Analysis of the effectiveness of 3-Tesla MRI in identifying denervation edema in the multifidus muscles for diagnosing cervical radiculopathy was presented. Employment of Short-Tau Inversion Recovery (STIR) MRI sequences to detect signal abnormalities indicative of denervation was given. Assessment of the correlation between MRI findings and clinical and electrophysiological data, emphasized the MRI's diagnostic value in differentiating cervical radiculopathy from other neuropathies, and evaluating the severity of muscle denervation. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Entrapment Neuropathies - Focus on enhancing nerve visibility in MRI scans was presented. Employment of T2-weighted two-point Dixon fast-spin-echo sequences, supplemented by principal component analysis (PCA) denoising and water-weighting (WW) techniques was reviewed. Methods aimed to reduce fat fraction error and improve fat suppression, thereby enhancing nerve conspicuity was detailed. Demonstration of techniques which significantly improved overall image quality, with effectiveness in enhancing nerve visibility in MR neurography was correlated with specific imaging examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Entrapment Neuropathies - Review of the diagnosis and management of suprascapular nerve entrapment, a condition causing shoulder pain and weakness was presented. Discussion of the importance of a comprehensive diagnosis involving physical exams, imaging, and nerve conduction studies was emphasized. Imaging techniques highlighting MRI for visualizing nerve pathologies and ultrasound for evaluating peripheral neuropathies and ganglion cysts were outlined. Discussion of various treatment options, ranging from conservative management to surgical interventions like arthroscopic and open decompression, and evaluates their effectiveness in relieving symptoms and improving shoulder function were detailed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Entrapment Neuropathies - Overview and examination of various compressive neuropathies affecting the median, ulnar, and radial nerves in the upper extremity was presented. Discussion into the etiologies, diagnosis, and treatment options for Carpal Tunnel Syndrome, Pronator Syndrome, Cubital Tunnel Syndrome, Guyon’s Canal Syndrome, and Radial Tunnel Syndrome was detailed. Presentation into diagnostic techniques like EMG and MRI, emphasizing their relevance in differentiating these conditions was emphasized. Treatment strategies, ranging from conservative to surgical approaches, are discussed, highlighting the importance of early diagnosis and individualized management plans for each neuropathy. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Investigation of the role of computed tomography angiography (CTA) in the rapid diagnosis and management of acute ischemic stroke (AIS) in children was discussed. Highlights of the clinical presentations of AIS, such as acute sustained hemiparesis and atypical symptoms like seizures and headaches were presented. Emphasis on the diagnostic utility of CTA in identifying arterial abnormalities and guiding thrombectomy and thrombolysis treatments was presented. Comparison of the effectiveness of CTA with magnetic resonance imaging/angiography (MRI/MRA) with emphasis the impact of initial imaging choice on the speed of diagnosis and treatment in pediatric stroke cases was detailed. Overview of readily available CTA can expedite the diagnosis and treatment of AIS, especially in patients with large vessel occlusion was given. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Detailed review of the anatomical variants of the anterior cerebral artery (ACA) and their clinical implications was given. Examination of the embryological development and different anatomical variations, including aberrant origins and associations with the ophthalmic artery, azygous ACA, and triplicated ACA was detailed and presented. Exploration of the formation of aneurysms in relation to these variants, emphasizing their importance in clinical practice for preventing patient injury during surgical interventions and aneurysm treatment was expressed. MRI and angiographic techniques used to identify these variants are discussed, showcasing their significance in neurovascular diagnostics. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Examination of patient selection methods for mechanical thrombectomy in stroke cases was presented. Comparison of clinical outcomes in patients chosen through noncontrast computed tomography (CT) against those selected by computed tomography perfusion (CTP) or magnetic resonance imaging (MRI) in an extended time window was reviewed and discussed. The evaluation of the effectiveness of each imaging modality in predicting patient outcomes post-thrombectomy, highlighting the potential of simpler and more accessible imaging methods in stroke treatment was outlined. Specific imaging films were presented and reviewed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Assessment of the impact of preoperative noncontrast CT (NCCT) screening for aortic calcifications on stroke rates in cardiac surgery patients was given. Comparison of the effectiveness of standard care with and without the addition of preoperative NCCT in reducing perioperative stroke was discussed. The utilization of noncontrast CT scans to identify aortic calcifications, aiming to evaluate whether this method can influence surgical approach and reduce stroke incidence in cardiac surgery was given and correlated to specific imaging examples. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Review of the efficacy of thin slice non-enhanced CT (NECT) scans for detecting intracranial aneurysms was given. Utilization of reconstructed thin slice maximum intensity projections (MIP) of NECT scans from patients with and without aneurysms was detailed and discussed. Evaluation of the sensitivity of detecting aneurysms based on their size, discussing that NECT can effectively identify a significant proportion of intracranial aneurysms larger than 7 mm was outlined. Review of research suggesting that patients with detected aneurysms should receive further vascular imaging for accurate diagnosis and treatment planning was given. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Investigation into the efficacy of AI-driven software for detecting the Hyperdense Artery Sign (HAS) in non-contrast CT (NCCT) scans of acute ischemic stroke patients was presented. Comparison of the performance of the software against trained physicians in identifying HAS, using NCCT scans from 154 patients, with and without large vessel occlusion (LVO) proven by CT angiography was provided with specific correlation to MRI scans. Evaluation of the sensitivity and specificity of both the software and human readers, demonstrating the potential of AI in assisting rapid stroke diagnosis in the context of MRI image interpretation. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - An extensive overview of the anatomical variations and clinical significance of the middle cerebral artery (MCA) in the context of ischemic stroke was provided. Details of MCA's phylogenetic development, branching patterns, and implications for thrombectomy procedures were correlated with advanced imaging films. Emphasis on the variability in MCA anatomy and its impact on stroke treatment, underscoring the importance of understanding these variations for effective stroke management and intervention strategies was detailed and discussed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Details of diagnostic strategies for ruling out subarachnoid hemorrhage with a critical evaluation of the diagnostic approaches for patients with sudden severe headaches in emergency settings, focusing on ruling out subarachnoid hemorrhage was given. Various diagnostic strategies, including the Ottawa SAH Clinical Decision Rule and the efficacy of CT scans and lumbar puncture procedures were presented. Emphasis on the importance of timely and accurate diagnosis to mitigate the risks associated with subarachnoid hemorrhage, providing valuable insights for clinical decision-making in emergency medicine was stressed and outlined. Specific case images were reviewed and integrated into the decision-making process. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Focus on the prognostic value of non-contrast computed tomography (NCCT) and CT perfusion (CTP) imaging in patients with acute ischemic stroke treated with thrombolysis was presented. Detailed review comparing automated and manual interpretations of the Alberta Stroke Program Early CT Score (ASPECTS) and the hyperdense vessel sign (HDVS) on baseline NCCT. Examination of the roles of NCCT and CTP in prognosis, emphasizing their utility in improving the accuracy of stroke assessments and treatment decisions was outlined and presented with a focus on specific imaging case evaluations. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Evaluation of the effectiveness of various diagnostic strategies for assessing non-traumatic sudden onset severe headaches in the emergency department was presented. A review and analysis of multiple diagnostic methods, including clinical decision rules, computed tomography (CT) scans performed within different time intervals after headache onset, lumbar puncture procedures, and CT angiography. Comprehensive insights into the accuracy, benefits, and limitations of these techniques in diagnosing conditions like subarachnoid hemorrhage were presented with specific case examples provided. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Outline of guidelines for evaluating vascular function and structure in isolated arteries and veins was presented. Detailed methodologies for assessing contraction, relaxation, and endothelial function in both large and small vessels were discussed. Emphasis was placed on the importance of consistent methodological approaches to ensure reproducible results in brain imaging. Review and discussion of the challenges and best practices in measuring vascular function, including considerations for the type of vessel, vascular bed, and the presence of endothelium were given. Specifics into standardize practices in vascular physiology research, enhancing the reliability and scientific validity of experimental findings were studied and presented including specific MRI images. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Exploration of the application of various deep learning models for forecasting patient flows in emergency departments (EDs) was presented. Evaluation of seven deep learning models, including Deep Belief Networks (DBN), Restricted Boltzmann Machines (RBM), and hybrid models like GRU-CNN and LSTM-CNN, using patient flow data from Lille Hospital, France was outlined. Overview of the model’s effectiveness in predicting daily patient visits, providing insights for better resource allocation and management in emergency departments was presented. Detailed review of brain MRI images was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Brain Imaging - Investigation of the impact of routine preoperative carotid Doppler ultrasound screening for asymptomatic carotid stenosis in patients undergoing coronary artery bypass grafting (CABG) was presented. Assessment of the prevalence of carotid stenosis, the relationship between carotid stenosis and postoperative stroke, and the value of routine screening in this patient population was presented. Overview of the use of Doppler ultrasound to evaluate carotid stenosis and employs statistical analysis to understand its correlation with postoperative stroke risk, providing insights into the efficacy of routine carotid screening before CABG was discussed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Demyelinating Disease - An in-depth analysis of the neuropsychiatric symptoms associated with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). Discussion into the cognitive and psychiatric symptoms observed in patients, discussing the patterns of MRI lesions, particularly in T2-weighted images, and their correlation with clinical manifestations was provided. Emphasis on the role of MRI in diagnosing CADASIL and explores the relationship between cerebral tissue lesions and cognitive as well as psychiatric symptoms, highlighting the need for further research in this area with detailed review of case images was provided. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Demyelinating Disease - Examination of the role of artificial intelligence (AI) in optimizing MRI protocols to minimize gadolinium use in multiple sclerosis (MS) patients was outlined. Exploration of the development and implementation of AI and machine learning techniques, particularly focusing on enhancing image quality and diagnostic accuracy while reducing gadolinium dosage was detailed and explained. Review of various AI-driven methods, including deep learning algorithms, for efficient and safer MRI imaging, suggesting a potential shift in radiological practices for MS diagnosis and monitoring was discussed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Demyelinating Disease - Focus on utilizing magnetic resonance imaging (MRI) features to cluster multiple sclerosis (MS) patients was detailed. Analysis of 103 MS patients using a 3T GE scanner with various sequences, including 3D T1W BRAVO, 2D T2W Fast Spin Echo (FSE), 3D T2W FLAIR CUBE, and 3D FAST-T2 for Myelin Water Fraction (MWF) mapping. Classification of patients based on lesion-level MRI features evaluating the clinical significance of these clusters was presented. Demonstration of the potential of MRI features, especially lesion MWF and volume, in distinguishing patient groups with different levels of disability was outlined and presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Demyelinating Disease - Analysis of the assessment of myelin imaging in the spinal cord using quantitative MRI techniques was presented. Utilization of a 7T MRI scanner with a multicomponent-driven equilibrium single-pulse observation of T1 and T2 protocol, generating detailed maps of apparent proton density, T1, T2, myelin water, intracellular water, and free-water fraction was outlined and discussed. Correlation of these MRI findings with histological markers, providing valuable insights into the microstructural changes in MS lesions was detailed. Research demonstrating the potential of high-resolution quantitative MRI in understanding and diagnosing multiple sclerosis was reviewed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Demyelinating Disease - Investigation of the differentiation of multiple sclerosis (MS) plaques using diffusion-weighted MRI was presented. Specific examination of whether the orientationally averaged water diffusion coefficient (⟨D⟩) can distinguish between plaques of varying severity in MS patients, and explores correlations between ⟨D⟩ values, disease duration, Expanded Disability Status Scale (EDSS) scores, and signal intensity on T1-weighted MR images was detailed and explained. Focus on patients with relapsing-remitting and secondary-progressive MS, using diffusion-weighted echo-planar imaging sequences to obtain ⟨D⟩ measurements, providing insights into the pathological differences between MS subtypes was provided. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Demyelinating Disease - Focus on the advances and challenges of using ultra-high field (UHF) MRI for spinal cord imaging in multiple sclerosis (MS). The potential benefits of UHF MRI, such as improved lesion detection and characterization, and advanced imaging techniques like functional MRI and MR spectroscopy was outlined and described. Discussion of technical challenges including field inhomogeneities, physiological motion, and sequence optimization was provided. Emphasis was placed on the need for further research to maximize the clinical utility of UHF MRI in MS. Specific MRI sequences and their applications in spinal cord imaging are detailed, providing a comprehensive overview of current capabilities and future directions in this field. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - Exploration of the use of functional magnetic resonance imaging (fMRI) in predicting post-traumatic stress disorder (PTSD) symptom trajectories in trauma survivors. Review of resting-state and task-based fMRI data, analyzing them with a novel deep learning model was detailed. Modeling using per-region encoding and pairwise attention to create a co-activation map for multi-label classification was reviewed. Enhancing understanding of the neurobiological underpinnings of PTSD, aiding in early intervention and treatment strategies was outlined and emphasized. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - The presentation focused on imaging signs of spontaneous and traumatic cervical artery dissection (CAD), comparing the efficacy of CT angiography (CTA) in detecting these conditions. It highlights the use of 128-slice dual-source CT scanners and specific imaging signs like intimal flaps, intramural hematoma, and vessel stenosis or occlusion. Emphasis was to guide neuroradiologists in differentiating between spontaneous and traumatic CAD using CTA, emphasizing the importance of imaging in the diagnosis and management of these conditions. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - Discussion and presentation of acute myelopathy in children, focusing on differential diagnosis and management. Emphasizing the importance of neuroimaging, particularly MRI, in diagnosing conditions like transverse myelitis, spinal cord ischemia, and spinal cord injury without radiographic abnormality (SCIWORA). MRI sequences used include T2-weighted images to identify spinal cord hyperintensities and diffusion-weighted imaging for ischemic conditions was reviewed in detail. The role of a comprehensive clinical evaluation, aided by advanced imaging techniques, in accurately diagnosing and managing pediatric acute myelopathy was emphasized. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - An extensive review of neuroimaging techniques in the assessment of acute and chronic neurotrauma was presented. Discussing various imaging modalities, including CT and MRI, focusing on their application in traumatic brain injury (TBI) and spinal cord injury (SCI). Key imaging sequences highlighted include T2-weighted FLAIR, diffusion-weighted imaging (DWI), gradient-recalled echo (GRE), and susceptibility-weighted imaging (SWI) for identifying traumatic injuries and their sequelae. Emphasis was placed on the role of neuroimaging in diagnosing, managing, and understanding the pathophysiology of neurotrauma, highlighting the advancement of imaging technologies in this field. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - Presentation of multi-modal analysis of resting-state fMRI data in mild traumatic brain injury (mTBI) patients, focusing on the association with neuropsychological outcomes was detailed. It employs resting-state fMRI techniques, specifically Amplitude of Low-Frequency Fluctuations (ALFF) and Regional Homogeneity (ReHo), integrated with graph theory methods. Focus is to explore and identify dysfunctional brain regions in acute mTBI, correlating these findings with neuropsychological assessments. The approach offers insights into the brain's compensatory mechanisms following mTBI, highlighting the potential of rs-fMRI in evaluating brain function post-injury. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - Review of orbital myositis mimicking status migrainosus was presented. Discussion of the importance of neuroimaging in differentiating between the two conditions was detailed. Brain magnetic resonance imaging (MRI) with a focus on high signal intensity in the left medial rectus muscle on T2-weighted images was presented. Further investigation with orbital MRI showed high signal intensity and thickening in the left medial rectus muscle, including the tendon, on fat-saturated T2-weighted images, and gadolinium enhancement on T1-weighted images. These findings were indicative of myositis, leading to a diagnosis of idiopathic orbital myositis. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - Outline of a pediatric fast magnetic resonance imaging (fbMRI) protocol for traumatic brain injury surveillance was presented. The imaging protocol includes T2-weighted half-Fourier acquisition single-shot turbo spin echo (HASTE) in axial, sagittal, and coronal planes; diffusion-weighted imaging (DWI); apparent diffusion coefficient (ADC) in the axial plane; T2-weighted FLAIR in the axial plane; and gradient echo (GRE) in the axial plane. This protocol serves as an alternative to computed tomography (CT), offering rapid, non-ionizing surveillance imaging for pediatric traumatic brain injuries. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - Evaluation of the prognostic role of MRI biomarkers in mild traumatic brain injury (TBI) was presented. Highlights of the use of diffusion tensor imaging (DTI) for detecting white matter changes and their correlation with symptom persistence was as detailed. Demonstration of changes in cerebral white matter and cerebrospinal fluid volumes, detectable via advanced MRI methods post-injury, where shown to be linked with the evolution of symptoms. Review underscored the potential of early imaging, particularly DTI, in predicting outcomes in mild TBI, providing valuable insights for clinical management and prognosis. Specific DTI metrics mentioned include mean diffusivity (MD) and fractional anisotropy (FA) were discussed to detect changes in white matter tracts, correlating with the evolution of symptoms post-injury. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - Review of the effectiveness of neuroimaging in patients with isolated neuro-ophthalmological complaints in the emergency department. The predictive value of presenting symptoms and physical examination findings for positive neuroimaging outcomes was presented. Emphasis was on the use of CT and MRI, noting their diagnostic yields in various neuro-ophthalmological scenarios. Specific symptoms and exam results that could guide emergency physicians in deciding when to utilize neuroimaging, aiming to optimize patient care and resource utilization. Focus was on detailed neuroimaging sequences in the diagnosis and management of this pathological condition. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - Review of identifying older emergency patients at risk of intracranial bleeding post-fall was presented. Outline of a protocol to derive a clinical decision rule, emphasizing the evaluation of patients aged 65 and above after a fall. Key elements include assessing risk factors, utilizing CT imaging of the head, and identifying indicators predictive of intracranial bleeding. The aim is to improve decision-making in emergency departments, reducing unnecessary imaging while ensuring prompt diagnosis and treatment for those at risk. Specific examples of advanced imaging protocols were presented and reviewed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - Presentation of traumatic injuries to the petrous part of the temporal bone was discussed. It covers the anatomy, mechanisms of injury, and classification systems of fractures, focusing on radiological findings. The use of computed tomography (CT) in identifying fracture lines and associated complications is emphasized. Discussion of various fracture types, such as longitudinal, transverse, and otic capsule-violating, their clinical implications, and the importance of accurate radiographic reporting to guide treatment. MRI sequences, particularly high-resolution CT and MR angiography are mentioned for evaluating complex cases and vascular injuries. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Neuroimaging of the Head, Neck and Spine - A comprehensive analysis of traumatic injuries to the spinal cord and peripheral nervous system was presented. The pathophysiology, clinical manifestations, and diagnostic approaches, emphasizing the use of MRI for detailed visualization of spinal cord and nerve root injuries was detailed. Specific MRI sequences, such as T2-weighted and STIR images, are highlighted for their effectiveness in identifying edema and nerve root avulsion. Discussion of management strategies, including surgical and non-surgical options was presented, underscoring the importance of interdisciplinary collaboration in the treatment and rehabilitation of these injuries. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – The Carotid Space - Focus on Carotidynia, presenting its etiology, evaluation, and management options. Identification of Carotidynia as a rare vascular disorder characterized by atypical neck and facial pain, often associated with tenderness over the carotid artery bifurcation. Review of the importance of imaging in diagnosis, particularly neck ultrasound showing hypoechoic thickening and mild luminal narrowing at the site of tenderness. MRI sequences, specifically T1-weighted images enhanced with gadolinium, are noted for their ability to suggest Carotidynia through increased uptake or enhancement involving the distal common carotid artery and carotid bulb. Emphasis was placed on the role of an interprofessional team in managing Carotidynia and improving patient outcomes. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – The Carotid Space - An evidence-based review of the diagnosis and management of Ludwig's Angina, with a focus on emergency medicine was presented. It discusses the pathophysiology, clinical presentation, and diagnostic approach, including the utilization of imaging modalities like Computed Tomography (CT) of the neck with intravenous contrast. Detailed imaging sequences were reviewed. The review emphasizes the importance of rapid airway management, the use of point-of-care ultrasound, and the application of broad-spectrum antibiotics for treatment. The objective is to equip clinicians with the necessary knowledge for rapid recognition and effective management of this potentially life-threatening condition. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – The Carotid Space - An academic synopsis focusing on the pathology and cardiovascular management of Loeys–Dietz syndrome (LDS), an autosomal dominant genetic disorder, was presented. Current evidence regarding the pathophysiology, diagnosis, and management strategies for LDS, emphasizing the syndrome's vascular manifestations, particularly aortic aneurysms was outlined. Discussion of the genetic underpinnings of LDS, including mutations in TGFBR1 and TGFBR2 genes and their clinical implications was provided. Emphasis was on the importance of regular surveillance and prophylactic interventions for life-threatening aortic emergencies in LDS patients. The challenges in managing LDS, advocating for a multidisciplinary approach involving cardiovascular surgeons, radiologists, and genetic counselors was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – The Carotid Space - Outline of nonatheromatous carotid artery disease aimed to enhance understanding of various nonatheromatous pathologies affecting the carotid arteries was discussed. The learning objectives centered around the effective use of different imaging modalities, including ultrasound, computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography, for accurate diagnosis. Special emphasis was placed on recognizing the unique imaging characteristics of nonatheromatous diseases, such as carotid dissection and congenital anomalies, to differentiate them from more common atheromatous conditions. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – The Carotid Space - Review of aberrant common and internal carotid arteries aimed to enhance understanding of their surgical implications was presented. The learning objectives included mastering the interpretation of specific MRI sequences, such as T1-weighted, T2-weighted, and MR angiography, to identify anatomical variations and potential complications in carotid artery pathologies. This focus was crucial in preoperative planning and in reducing surgical risks associated with these anomalies. Emphasis was placed on the need for comprehensive vascular imaging in patients undergoing head and neck surgeries to ensure accurate diagnosis and effective intervention strategies. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – The Carotid Space - Review of common carotid artery trifurcation was presented; it detailed the significance of recognizing the common carotid artery trifurcation as a potentially dangerous anatomical variant. The learning objectives included understanding the implications of this variant on surgical and interventional procedures. The study emphasized the importance of preoperative imaging, particularly using MRI, to identify these anatomical variations, which are crucial for avoiding complications during head and neck surgeries and endovascular interventions. The focus was on enhancing patient safety by integrating advanced imaging into surgical planning. Detailed review of MRI sequences was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – The Carotid Space - Detailed analysis of Lemierre syndrome’s high risk of thromboembolic complications and mortality was presented. The learning objectives centered on understanding the pathophysiology of Lemierre syndrome, its clinical presentation, and the risks associated with it. Emphasis was placed on the use of imaging techniques, specifically MRI, to detect thrombosis and abscesses in these patients, aiding in the diagnosis and management of this serious condition. The importance of early recognition and appropriate treatment to improve patient outcomes was emphasized. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – The Carotid Space - Presentation of on the comprehensive evaluation of carotid space pathology using various MRI sequences. The learning objectives included detailed interpretation of T1-weighted, T2-weighted, and post-contrast fat-saturated T1-weighted MRI images. These sequences were crucial in differentiating between various pathologies within the carotid space, such as paragangliomas, nerve sheath tumors, and carotid artery pathology. Emphasis was placed on understanding the unique signal characteristics and enhancement patterns of these lesions to aid in accurate diagnosis and effective treatment planning. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions – An in-depth analysis of thoracic spinal extradural arachnoid cysts. The learning objectives included mastering the interpretation of key MRI sequences: T2-weighted imaging for detailed visualization of cysts and surrounding structures, STIR sequences to evaluate associated edema, and gadolinium-enhanced T1-weighted imaging for enhanced contrast and detail. The emphasis was on accurate diagnosis, understanding the cyst's impact on surrounding structures, and evaluating surgical outcomes through postoperative MRI assessments. These objectives aimed at improving the management and treatment of spinal extradural arachnoid cysts. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions – Details of the diagnosis and management of thoracic spinal extradural arachnoid cysts was presented. The learning objectives included mastering the interpretation of specific MRI sequences, particularly T2-weighted imaging (WI) in sagittal and axial planes, sagittal STIR, and gadolinium-enhanced T1-WI. These sequences were essential in identifying CSF-like signal abnormalities and assessing spinal cord compression. Emphasis was placed on the surgical treatment and postoperative MRI evaluation to ensure successful resolution of the cyst and spinal decompression. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions – The analysis of solitary osteochondroma affecting both the rib and the adjacent vertebral body was presented. The learning objectives included interpreting MRI sequences for accurate diagnosis, specifically employing axial T1-weighted, axial contrast-enhanced fat-saturated T1-weighted, and coronal fat-saturated T2-weighted magnetic resonance images. These sequences were crucial in identifying the characteristic features of the osteochondroma, such as the cartilage cap and the involvement of the rib and vertebral body, guiding towards a precise preoperative assessment and effective treatment planning. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions – Emphasis was on distinguishing spinal infections from other spinal disorders using MRI imaging techniques. The learning objectives included interpreting various MRI sequences, such as T1-weighted, T2-weighted, STIR (Short Tau Inversion Recovery), and DWI (Diffusion Weighted Imaging), to identify specific characteristics of spinal disorders. The importance of recognizing the signal intensity changes in different spinal conditions, highlighting the role of advanced imaging techniques in accurate diagnosis and effective treatment planning for spinal disorders was detailed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions - Outline on evaluating the diagnostic yield of culture in native vertebral osteomyelitis, emphasizing the importance of image-guided vertebral biopsy. The learning objectives included analyzing the sensitivity and specificity of bone and disc cultures, using MRI and CT imaging techniques for targeted biopsies. The study reinforced the necessity of histopathologic examinations in culture-negative cases and the potential benefits of repeat biopsies. This comprehensive approach aimed to enhance diagnostic accuracy in vertebral osteomyelitis, improving patient management through more targeted and effective treatment strategies. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions - Focus was on diastematomyelia, presenting minimal neurologic deficits. The learning objectives included understanding the imaging features of diastematomyelia using specific MRI sequences. These comprised T2-weighted images for spinal cord and nerve root visualization, T1-weighted images for vertebral body assessment, and STIR sequences for evaluating associated soft tissue changes. The emphasis was on recognizing these MRI patterns in atypical presentations, particularly in adults, and integrating them into clinical assessments to improve diagnostic accuracy and inform treatment strategies for this rare spinal anomaly. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions - Presentation aimed to refine the diagnostic approach to spinal tuberculosis (TB) using MRI. The learning objectives included mastering the interpretation of T1-weighted, T2-weighted, and STIR (Short Tau Inversion Recovery) sequences, as well as understanding the utility of gadolinium-enhanced imaging. Emphasis was placed on identifying characteristic MRI features of spinal TB, such as vertebral body involvement, disc changes, and paraspinal abscess formation, to differentiate it from other spinal pathologies and enhance clinical decision-making in TB management. diagnostics. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions – Outline of the computational analysis of vertebral body for compression fracture using texture and shape features was presented and enhanced the diagnostic accuracy of vertebral body (VB) compression fractures using MRI. Emphasis was placed on the utilization of T1-weighted median sagittal MRI slices for computational analysis. Learning objectives revolved around developing proficiency in analyzing VBs through automated machine learning techniques, focusing on texture and shape feature extraction. The approach improved differentiation between normal, benign, and malignant vertebral bodies, highlighting the potential of advanced computational methods in spinal imaging diagnostics. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions – Outline provided comprehensive learning objectives on the diagnosis and management of primary and secondary spinal cord tumors. Focus was on interpreting advanced MRI sequences, specifically T2-weighted, diffusion-weighted, and fluid-attenuated inversion recovery (FLAIR) imaging. Learning objectives included understanding neuroanatomical compartmentalization of these tumors and their genetic and histological profiles. Emphasis was placed on the application of targeted therapies, the role of surgical interventions, and the significance of genetic markers in prognosis and treatment strategies. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions – Outline of the differentiation between benign and malignant vertebral compression fractures using qualitative and quantitative analysis of a single fast spin echo T2-weighted Dixon sequence was presented. Emphasis was aimed to enhance diagnostic proficiency in distinguishing between benign and malignant vertebral compression fractures. Focus was on improving the accuracy and reliability of MRI assessments using a novel imaging technique. Learning objectives centered on the evaluation of the diagnostic performance of this imaging method, both qualitatively and quantitatively, facilitating a more precise and efficient approach to spinal fracture assessment in clinical practice. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023.
MRI Mastery Series – Extradural Lesions- Detailed examination of primary osseous chondrosarcoma in the lumbar spine. Discussion of the complexities and challenges in diagnosis and treatment, emphasis was placed on the effectiveness of two-stage surgery for total tumor removal and spinal stabilization. Comparison of one-stage and two-stage surgical approaches, highlights of the importance of en bloc resection in the management of such cases to reduce recurrence and ensure better outcomes was correlated to patient symptoms and imaging findings in the sagittal and coronal planes. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions– Review and discussion of a sequestered disc herniation mimicking psoas abscess was presented. Details of a unique case of sequestered disc herniation initially misdiagnosed as a psoas abscess was outlined. Underscoring the diagnostic complexity of such cases, emphasis was placed the importance of differential diagnosis in spinal pathology. Highlights of the necessity of considering sequestered disc herniation in the differential diagnosis of psoas abscess, particularly when clinical and imaging findings are atypical. Overview of the understanding of spinal pathologies and the need for careful evaluation to avoid misdiagnosis and inappropriate treatment was reviewed along with appropriate images. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions - A report and review of the literature examining a rare case of spontaneous spinal subdural hematoma (SSDH) concurrent with idiopathic intracranial subarachnoid hemorrhage. Exploration of the diagnostic challenges, emphasis on the necessity of prompt surgical intervention for SSDH, and discussion of the potential etiologies and clinical presentations of this unusual condition. Contribution to the understanding of SSDH's pathogenesis and highlighting of the importance of considering it in differential diagnoses of acute spinal emergencies was detailed and presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Extradural Lesions - An extensive review of spinal tumors based on the WHO's 5th Edition classification. Identification of 92 out of 163 bone and soft-tissue tumor entities with spinal manifestations. Emphasis placed on the importance of precise preoperative tissue diagnosis and interdisciplinary discussions for effective surgical planning. Discussion of tailoring surgical approaches to the unique biological behavior of each tumor, highlighting the significance of understanding tumor growth patterns, metastatic potential, and age incidence for optimal treatment strategies was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Extramedullary Spinal Tumors - Extensive review of MRI protocols for spinal imaging was presented. Coverage of various MRI sequences and their applications in assessing different spinal structures, including white matter, gray matter, vessels, and bone was detailed. Emphasis was placed on the importance of sequence selection based on clinical scenarios and pathology. Practical tips for overcoming imaging challenges was reviewed and discussed. The study is significant for its detailed guidance on optimizing MRI techniques for accurate diagnosis and management of spinal conditions. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Extramedullary Spinal Tumors - Examination of the diagnostic use of signal intensity (SI) ratios in differentiating schwannomas from meningiomas was outlined. Demonstration that schwannomas typically have higher SI ratios compared to meningiomas on T2-weighted MRI images was outlined. Improved accuracy in preoperative diagnoses, crucial for determining appropriate surgical approaches was presented. Findings contributing significantly to the understanding and management of these spinal tumors, highlighting the utility of SI ratios in MRI as a diagnostic tool was reviewed and discussed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023.
MRI Mastery Series – Intradural Extramedullary Spinal Tumors - A retrospective analysis of MRI features of 199 patients distinguishing between two specific tumor types, schwannoma and meningioma. Discussions related to schwannomas significantly exhibiting cystic changes and lumbar location, while meningiomas commonly showing dural tail signs, thoracic location, and were smaller in size were presented. Review that cystic changes and dural tail signs are key differentiators, and that MRI is an effective tool for accurately diagnosing these spinal tumors was outlined and presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Extramedullary Spinal Tumors - Investigation of spinal hemangioblastomas, focus was on surgical outcomes and factors influencing prognosis. Cases treated over 35 years were reviewed, with analysis of the impact of surgery type, intraoperative neuromonitoring (IONM), and preoperative conditions on patient outcomes. Key findings included a better outcome with laminotomy compared to laminectomy, with a trend towards improved outcomes with IONM use. The study emphasized the importance of surgical approach and preoperative neurological condition in predicting patient recovery and managing spinal hemangioblastomas effectively. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Extramedullary Spinal Tumors - Focus was on MRI as the primary diagnostic tool for spinal tumors, categorizing them into extradural, intradural extramedullary, and intramedullary. Highlights of MRI's effectiveness in identifying tumor location, shape, extent, and enhancement patterns, aiding in differential diagnosis were outlined and presented. Demonstration that spinal tumors are more prevalent in men and adults, with a significant occurrence in the 41-50 age group was discussed. Emphasis was placed on MRI's role in improving anatomic delineation, early diagnosis, and monitoring treatment responses in spinal tumor cases. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Extramedullary Spinal Tumors - A critical analysis of using 3D MRI in diagnosing disc sequestration cases that resemble tumors was presented. Highlights of two specific instances where conventional MRI techniques led to a neurinoma suspicion, but 3D MRI revealed clear boundaries between the mass and nerve root, ruling out neurinoma. The effectiveness of 3D MRI in distinguishing between disc-related issues and tumors, potentially reducing the need for invasive surgery was reviewed and discussed. Emphasis was placed on the importance of accurate diagnostic tools in spinal health, showcasing 3D MRI's potential in enhancing patient outcomes. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Extramedullary Spinal Tumors - A comprehensive examination of various spinal tumors located within the dura but outside the spinal cord. Emphasis is placed on the radiologic and pathologic features of these tumors, with a specific focus on diagnostic imaging appearances. Key tumors discussed include meningiomas, schwannomas, neurofibromas, and malignant peripheral nerve sheath tumors. Details of common and uncommon manifestations, insights into their clinical presentations, imaging characteristics, and treatment implications. Highlights of the crucial role of imaging in diagnosis and management, underscoring the importance of correlating radiologic findings with pathologic features for accurate interpretation and treatment planning was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Extramedullary Spinal Tumors - Detailed exploration of Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP), concentrating on diagnostic complexities and treatment methodologies. Underscoring the importance of accurate clinical and electrodiagnostic interpretations to prevent misdiagnosis. An extensive review of current treatments like intravenous immunoglobulin, corticosteroids, and plasma exchange, with discussion of management strategies for treatment-resistant cases. Emphasis was placed on the importance of using objective outcome measures for treatment efficacy evaluation. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Intramedullary Spinal Lesions – overview of traumatic and vascular disorders of the spinal cord including hemorrhage of the spinal cord, cavernoma and dural arteriovenous fistula was presented. Focused detail on Type II dural arteriovenous fistula and potential clinical consequences was given. Intramedullary arteriovenous malformations in the setting of type II dural arteriovenous fistula and its clinical correlation on magnetic resonance angiography was presented along with common causes and imaging sequences of spinal cord ischemia/infarction. National Spine Management Group, National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Intramedullary Spinal Lesions – details of infection and inflammation disorders of the spine. Review of imaging presentation of acute disseminated encephalomyelitis of the spinal cord with emphasis being placed on case presentations. Presentation on Chiari 1 with syringohydromyelia was detailed and reviewed. Congenital lesions of the spinal cord with specific focus on the intradural intramedullary space were given. Both cysticercosis and sarcoidosis of the spinal cord were outlined and discussed with specific case study presentations. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Intramedullary Spinal Lesions – detailed presentation and review of the demyelinating diseases of the spine including multiple sclerosis of the spinal cord, idiopathic acquired transverse myelitis and vacuolar myelopathy. Review and discussion of acquired metabolic disorders of the spinal cord including subacute combined degeneration from copper deficiency and spinocerebellar ataxia. Additional discussion and outline of machine learning applications in spinal MRI. Contextual presentation relating to the study of the demography, incidence, symptoms, histopathology, postoperative complications, and recovery in spinal cord tumor patients. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Intramedullary Spinal Lesions – analysis of neoplasms of the spinal in the intradural intramedullary space of the spine. Detailed review of ependymoma associated/ non-associated with neurofibromatosis 2 myxopapillary ependymoma was presented and discussed. Presentation on the evaluation of cervical spinal cord astrocytoma and glioblastoma was outlined with correlation to case discussions. Hemangioblastoma of the spinal cord and conus medullaris was explained in detail with specific review of imaging acquisition and analysis. Overview and presentation of the neurological and spinal cord manifestations of Von Hippel Lindau Disease was provided along with outline of imaging presentations of cervical spinal cord ganglioglioma and a rare case of spinal cord lipoma. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Intradural Intramedullary Spinal Lesions – review of spinal cord anatomy and localization of spinal cord lesions on MRI with a particular focus on intradural intramedullary spinal cord lesions. Overview and general outline of spondylomyelopathy with correlation to specific findings on MRI studies was presented. Discussion on the etiology of the disease process from ossification of the posterior longitudinal ligament. Presentation on disease progression to include spinal cord atrophy and downstream sequalae was outlined. Details of MRI pulse sequences for spine imaging relating to visualization of the spinal cord were outlined and presented including sagittal T1, sagittal T2, sagittal STIR, axial GRE in the cervical spine, axial T2W. Additional special sequences including diffusion weighted imaging (DWI), diffusion tensor imaging (DTI) and apparent diffusion coefficient (ADC) were presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Degenerative Diseases of the Spine – degenerative changes related to the vertebral endplates were presented and detailed. Modic classification of degenerative bone marrow changes were outlined with specific attention paid to Modic I and Modic II endplate changes. Comparison between T1, T2 and STIR images were compared. The correlation between gene expression and MRI STIR signals in patients with chronic low back pain and modic changes was discussed in detail. Symptomatic versus asymptomatic spinal disease was presented with clinical correlation to advanced imaging images. Recurrence of lumbar intervertebral disc herniation after open spine surgery was reviewed and presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Degenerative Diseases of the Spine – Anatomy of the intervertebral disc was reviewed and correlated to annular fissures. Analysis between degenerative pre-existing fissures and acute injury was presented and outlined. Terminology related to transverse, circumferential and radial tears was presented and discussed. The clinical importance of posteriorly projecting synovial cysts was explained and demonstrated. Additional comparison to degenerative joint disease related to intervertebral disc changes was discussed. Focus on the three-dimensional measurement of the facet joint in normal individuals and those with intervertebral disc herniations was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Degenerative Diseases of the Spine – analysis of appropriate reporting parameters in degenerative spinal disease was presented with specific examples provided. Anatomical features and location related to morphological changes in the intervertebral disc and surrounding joints were discussed and presented. Review of anatomical zones relating to intervertebral disc morphology including central and foraminal locations with their anatomical landmarks was detailed. Detailed analysis of uncovertebral degenerative disease, foraminal narrowing and ossification of the posterior longitudinal ligament was provided. Diffuse Idiopathic Skeletal Hyperostosis (DISH) was presented and outlined and discussed in terms of the association between ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Degenerative Diseases of the Spine – specific details related to the anatomy of the intervertebral disc was presented. A specific discussion related to intervertebral disc nomenclature and morphological presentation on MRI was presented. Detailed analysis of intervertebral disc protrusion versus intervertebral disc extrusion was outlined and compared. Parameters relating to the diagnosis of intervertebral disc sequestration along with clinical sequala were detailed. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – Degenerative Diseases of the Spine – overview and introduction to degenerative spinal diseases as determined by magnetic resonance imaging. Details related to MRI physics and pulse sequences related to degenerative spinal disease were presented and explained for the cervical, thoracic, and lumbar spines. Grading parameters of spondylolisthesis were discussed and detailed with specific focus on etiology and its influence on spinal stenosis. Common causes of acquired spinal stenosis were presented in the context of both acute and degenerative conditions. Changes to anatomical landmarks were outlined and its correlation to claudication. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – General Spine Disorders – presentation of the vascular anatomy of the spinal column as visualized on MRI studies was detailed. Specific focus was on the normal description of the arterial and venous drainage of the spinal cord. Review of the utilization of MR angiography and its ability to depict the vascular anatomy of the spinal cord was presented. The arterial vascular tree was presented including basilar artery, vertebral artery, subclavian, aorta and surrounding anterior and posterior spinal arteries. Venous vascular tree presentation included anterior and posterior spinal veins, vertebral vein, subclavian vein and other venous plexi associated with the spinal cord. Analysis and comparison of anatomical models and MR angiography with detailed imaging studies was presented. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – General Spine Disorders – analysis of anatomical landmarks in the spine on MRI was presented and reviewed. Counting of vertebral levels was demonstrated and explained with particular attention on wrong level surgery. Cadence of orientation during review of MRI films was emphasized. Anatomical review of spinal transition zones with detailed discussion on the morphological nuances of vertebral and other anatomical landmarks was discussed and presented. Overview of the historical progression of MRI science related. MRI physics, instrumentation, basic sequences, artifacts, safety, and contrast agents were presented. Additional overview of post-operative complications such as post-operative osteomyelitis, post-operative cervicalgia, and post-operative mycobacterium abscessus was demonstrated and correlated to post-operative pain. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – General Spine Disorders – detailed analysis of failed back surgery syndrome, post-operative dural tear/leak and cervical radiculopathy with neck pain was presented and outlined. Review of post and pre-operative arachnoiditis, loculated arachnoid arthritis and synovial cysts and the subsequent influence on spinal anatomy was presented. MRI as the gold standard in the diagnosis of arachnoiditis with attention to its specificity and sensitivity was discussed. Overview of symptoms such as paraparesis and other risk factors was outlined. Specific attention was paid to spin echo sequences and transverse relaxation times with focus on contrast of different tissue types. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – General Spine Disorders – overview and discussion of spinal tuberculosis pathology, post-surgical abscess and dural leak was presented. Relevant anatomy and clinical correlation were emphasized and reviewed. Details related to T1, T2 and STIR images were presented and compared. Attention was paid to the diagnosis of spinal arteriovenous fistula and post-surgical complications visible on MRI studies. Details related to the long-term outcomes and prognostic factors in patients with arteriovenous fistulas were outlined. Post-surgical extradural seroma/hematoma was reviewed and presented in detail. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
MRI Mastery Series – General Spine Disorders – Case and evidence-based detail review of neuromyelitis optica, pseudo-herniation, arthritis, and osteogenesis imperfecta tarda was presented. Focus was on the progression of reading MRI images pertaining to disorders of the human spine and their relationship to clinical findings. The focus was on the cervicocranial region was presented with detailed analysis of over vigorous decompression effects on regional anatomy. Analysis of the etiology, pathogenesis and treatments associated with ankylosing spondylitis, a common seronegative spondyloarthropathy and chronic inflammatory autoimmune disease was presented. Details of immune cells, innate cytokines, and human leukocyte antigen (HLA-B27) were outlined. National Spine Management Group, Cleveland University Kansas City, College of Chiropractic, Federation of Chiropractic Licensing Boards, Accreditation Council on Continuing Medical Education (ACCME) Joint Providership with MRI Online, Buffalo, NY, 2023
Primary Spine Care 15: Advanced MRI and X-Ray Documentation in Clinical Practice, Interpreting and utilizing X-ray and MRI findings in creating demonstrative documentation. Advanced identification of spinal disc lesions, herniations, bulges, protrusion, extrusion, and fragmentations through computer graphics. Identification and demonstrative documentation of vertebral motor unit pathology and reporting demonstratively using computer graphics. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Advanced MRI Interpretation in Clinical Practice, Utilization of thin slice acquisitions with T2 Fat suppressed, STIR, proton density, T1 and T2 sequencing for advanced identification of spinal disc lesions, herniations, bulges, protrusion, extrusion, and fragmentations. Better visualization of intradural and extradural lesions, neoplasms, and infections. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Ethics in Clinical Practice, Ethical, collaborative relationships with medical PCPs and specialists using advanced documentation and accurate reporting of imaging and advanced imaging. Creating a collegial relationship when conflicts arise in concluding accurate diagnosis to allow consensus and the evidence to determine final diagnosis. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Spinal CAT Scan Interpretation, Understanding the utilization of CAT Scan slicing and the reformatting when using bone and soft tissue windows. Correlating MRI to CAT Scan creates an unclear conclusion to render a complete image of the morphology of the indeterminate pathology. Understanding the physics of CAT Scan and the radiation levels with different types of CAT Scan technology. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Connective Tissue/Strain Sprain Pathology, Understanding the morphology and physiology of connective tissue at the cellular and extra-cellular levels in building a foundation to understanding the function and interaction of ligaments, tendons, muscles, and bones, Identifying connective tissue pathology and the repair process with a foundation of r permanent aberrant sequella. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Advanced Spinal Biomechanical Engineering, Understanding the concepts of normal vs. pathological movement of vertebral motor units in accurately concluding diagnosis on biomechanical pathology when considering excessive motion. An evidence-based approach to determining translation, angular deviation, and rotations beyond pathobiomechanical limitations in the spine. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Trends in Spinal Care, An evidence-based approach to concluding accurate diagnosis, prognosis, and treatment plan, Eradicating the non-specific back pain dogma utilizing X-ray digitizing based on literature standards, Creating treatment plans with identifying the primary spinal lesions using evidence-based tools. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Documentation in Clinical Practice, Understanding and including all historical elements; current history, history, family history, and social history when documenting a 99201, 99202, 99203, 99204, and 99205. The application of time as the prime element as per Medicode in coding examinations and re-examination with face to face, review of records and the time necessary to document in an electronic health record. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
2023 Demonstrative Documentation Requirements, Analyzing the requirements in anatomical diagnostic imagery to communicate spinal pathology. Integrating technology, clinical findings, and advanced graphic tools to communicate a diagnostic conclusion. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022
MRI Spine Advanced Clinical Case Grand Rounds, Clinical case review of MRI including intra and extra-dural findings inclusive of the disc and vascular anatomical lesions. Differentially diagnosing central cord lesions, and spinal cord vascular lesions in both acute trauma and degenerative presentations. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022
Non-Specific Spine Pain, Chiropractic and Outcomes, Analyzing neuro-biomechanical pathological lesions define primary spinal lesions and removes the dogma of non-specific back pain. Creating evidence-based demonstrative documentation in the creation of treatment plans. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022
Spinal Tumor MRI Interpretation, Diagnosing and documenting: Ependymoma, Astrocytoma, Hemangioblastoma, Lipoma, Meningioma, Neurofibroma, Schwannoma, Myxopapillary Ependymoma. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022
Demonstrative Narrative and Evaluation and Management Report Writing, Clinical record-keeping, why write clinical notes, the importance of context, what to include in a clinical note, tips for better clinical documentation, basic legal considerations, open clinical notes, how to keep documentation efficient. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022
Age-Dating Ligament/Connective Tissue Physiology and Pathology, Utilizing pain patterns, the high signal in the annulus, high signal outside the annulus, Modic changes, disc height, vacuum disc, sclerosis, Pfirrman rating, facet edema, and previous MRIs to determine the chronicity of pathology., Master-Class in ligaments; anatomy, physiology, vascularization, neurological innervation, tissue repair, and how they all relate to clinical practice. Ligament pathology correlates to the mechanisms of patho-neuro-biomechanical lesions (vertebral subluxation complex). Also, how ligaments play a critical role in the chiropractic spinal adjustment and in defining the chiropractic spinal adjustment mechanisms. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022
Clinical Grand Rounds in Biomechanics, Digitizing, and Advanced Imaging: Case reviews concluding and accurate diagnosis, prognosis, and treatment plan utilizing evidence-based instrumentation and algorithms. Using demonstrative reporting of case findings to collaborate with co-treating physicians. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022
Medical-Legal Documentation: A documentation discussion on meeting the requirements of the courts, carriers, and licensure boards in complete and accurate reporting. Ensuring the diagnosis, prognosis, and treatment plan are demonstratively documented. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022
2022 Trends in Spinal Healthcare, Analyzing evidenced-based spinal healthcare trends in both utilization and necessity and understanding the marketplace. The use of evidenced-based demonstrative documentation in reporting treatment pathways in triaging spinal pathobiomechanics. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
MRI Spine Clinical Case Grand Rounds, Clinical case review of MRI’s including sagittal, axial, T1, T2, STIR, and proton density sequences. Identified will be the vertebrate, spinal cord, discs, nerve roots, thecal sac, posterior longitudinal ligament, epidural veins, and fat saturation pulses. Pathology will include bulges, herniations, protrusions, extrusions, myelomalacia, cord edema, and Schmorl’s nodes. Learn how to collaborate effectively with radiologists, neuroradiologists, and neurosurgeons on the clinical findings. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Chiropractic vs. Physical Therapy vs. Medical Case Management and Outcomes, Analyzing evidence-based outcomes in triaging non-anatomical lesions. The analysis of neuro-biomechanical pathological lesions defines primary spinal lesions and removes the dogma of non-specific back pain. Managing collaborative relationships with medical primary providers and specialists in clinical practice. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
MSK Extremity Radiological Interpretation, Utilizing both MRI and x-ray in identifying via x-ray and advanced imaging extremity instabilities from ligamentous, osseous or neoplastic derangement. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Demonstrative Narrative and Evaluation and Management Report Writing, Effectively creating demonstrative medical-legal documentation and meeting the needs of the courts, and making your "4-Corner" (narrative) report to build your reputation as an evidence-based provider. The step-by-step minutiae of building a report, accomplishing report writing timely and effectively by understanding the regulatory and administrative rules. Learn how to educate the lawyer on bodily injury through evidence-based demonstrative reporting. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Ligament/Connective Tissue Physiology and Pathology, Master-Class in ligaments; anatomy, physiology, vascularization, neurological innervation, tissue repair and how they all relate to clinical practice. Ligament pathology correlates to the mechanisms of patho-neuro-biomechanical lesions (vertebral subluxation complex). Also, how ligaments play a critical role in the chiropractic spinal adjustment and in defining the chiropractic spinal adjustment mechanisms. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Stroke Evaluation and Risk Factors in the Chiropractic Practice, Diagnosing, triaging, and documenting headaches, migraines, and vascular incidents (stroke) in the primary provider's office. Imaging protocols based upon history and clinical presentation will be presented, along with analyzing imaging findings in determining the etiology. There will be an extensive question and answer session following the instructional presentation. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Age-Dating Herniated Discs and Trauma, Age dating herniated discs and trauma is a critical skill for an expert in spine. It combines the clinical skills of interpreting X-ray, MRI, and other imaging modalities with a clinician's understanding of joint pathology. This level of expertise is critical when collaborating with other physicians or working in the medical-legal environment as an expert. Age dating pathology is also central to creating a prognosis on your patient's recovery and must be evidence-based in rationale. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Clinical Grand Rounds in Spinal Biomechanics, Case reviews utilizing E/M, MRI, and x-ray mensuration report to conclude an accurate diagnosis, prognosis, and treatment plan. Common diagnosis requiring interprofessional collaboration with a discussion of diagnostic dilemmas and proper communication methods. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Neurosurgical Grand Rounds, A clinical discussion of collaborating with neurosurgeons on spinal cord and spinal nerve root co-morbidities. Triaging cases with herniated, protruded, extruded, fragments discs and differentially diagnosing tethered cord, syringomyelia, traumatic Schmorl’s Nodes, Myelomalacia, spinal cord edema, vacuum disc and other intra, and extra-dural lesions. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Patient Intake, History and Physical Examination, Determining the etiology of the patient's complaints in a traumatic or non-traumatic scenario. Analyzing the patient's past history and review of systems along with the performance of a completeorthopedic, neurological and clinical examination to correlate both past, current and causality issues to formulate an accurate diagnosis, prognosis and treatment plan. There is an emphasis on triaging both the trauma and non-trauma patients. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021
Connective Tissue Spinal Disc Permanent Pathology, Primary Spine Care, Herniated, bulged, protruded and extruded discs, etiology and morphology. Age-dating disc pathology inclusive of Modic changes, piezoelectric effect, Wolff’s Law and radicular clinical presentation. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
Connective Tissue Pathology and Research, Primary Spine Care, Utilization in spinal models considering the opioid abuse and various spinal models in contemporary health care. Care paths for mechanical spine pain and the evidence for conservative chiropractic care. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
Bio-Neuro-Mechanical Lesions and Spine Care, Primary Spine Care, Mechanoreceptor, proprioceptor, nociceptor innervation and control of the spinal system with central nervous system action and interaction. The integration of the pain processing network and the HPA Axis (hypothalamus, adrenal and pituitary) with the chiropractic spinal adjustment. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
Ethics, Documentation and Research, Primary Spine Care, Maintaining ethical Interprofessional relationships based upon an evidenced based practice inclusive of triage, diagnostics and reporting. Creating thorough documentation that reflects your complete findings encompassing descriptive ICD-10 codes and concludes the presence or absence of pathology. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
Evidenced Based Care in a Collaborative Setting; Primary Spine Care 5, A literature based model for collaborating with hospitals, medical primary care providers and specialists. Reviewing the documentation requirements to communicate the diagnosis, prognosis and treatment plans with medical entities and having the evidence as a basis for those recommendations. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Current Literature Standards of MRI Spine Interpretation; Primary Spine Care 5, MRI Spine Interpretation of the spine. How to triage a trauma and non-trauma with advanced imaging and document the necessity. We will also cover the basics of MRI Spine Interpretation inclusive of all types of herniations, bulges, Academy of Chiropractic Post-Doctoral Division. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Spine Brain Connection in Pain Pathways; Primary Spine Care 5, MRI Spine The spine-brain connection in managing chronic pain patients. Understanding how chronic pain negatively effects brain morphology and potential pathology as sequella. The role of chiropractic in preventing the loss of gray matter and the most recent evidence as outlined in indexed peer reviewed literature over the last 10 years verifying chiropractic’s role. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Bio-Neuro-Mechanical Mechanism of the Chiropractic Spinal Adjustment; Primary Spine Care 5, The biological, neurological and mechanical mechanisms and pathways from the thrust to the dorsal horn and brain connection and how the brain processes the chiropractic spinal adjustment based upon the literature. Care paths of chiropractic and physical therapy from an outcome basis, Academy of Chiropractic Post-Doctoral Division. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021
Interprofessional Hospital Based Spine Care, Trends in hospital and emergent care in the healthcare delivery system inclusive of policies, hospital staffing and current care paths for mechanical spine issues. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021
Evaluation and Management, An overview of the evaluation and management process inclusive of utilizing electronic medical records to conclude evidenced-based conclusions with the utilization of macros. The importance of adhering to an academic standard and considering co-morbidities. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Evaluation and Management, Concluding a chief complaint, history and what needs to be considered in a physical examination. This covers in dept the required elements for chief complain, history of present illness, review of systems, and past, family, and/or social history. This module also covers the following components of a physical examination: observation, palpation, percussion, and auscultation. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Evaluation and Management, Coding and Spinal Examination: Detailing 99202-99205 and 99212-99215 inclusive of required elements for compliant billing. It reviews the elements for an extensive review of systems, cervical and lumbar anatomy and basic testing. The course also covers the basics of vertebra-basilar circulation orthopedic assessment. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Evaluation and Management, Neurological Evaluation: Reviewing complete motor and sensory evaluation inclusive of reflex arcs with an explanation of Wexler Scales in both the upper and lower extremities. The course breaks down testing for upper and lower motor neuron lesions along with upper and lower extremity motor and sensory testing examinations. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Evaluation and Management, Documenting Visit Encounters: Forensically detailing the S.O.A.P. note process for visit encounters and discussing the necessity for clinically correlating symptoms, clinical findings and diagnosis with the area(s) treated. It also details how to modify treatment plans, diagnosis, document collaborative care and introduce test findings between evaluations. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Evaluation and Management, Case Management and Treatment Orders: This module discusses how to document a clinically determined treatment plan inclusive of both manual and adjunctive therapies. It discusses how to document both short-term and long-term goals as well as referring out for collaborative care and/or diagnostic testing. It also includes how to prognose your patient and determine when MMI (Maximum Medical Improvement) has been attained. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Interpretation sequencing of STIR, T1, T2, Axial and Sagittal acquisitions. Landmarks, physics, and literature-based definitions of disc and osseous pathology, Visualizing, diagnosing, and documenting cervical and lumbar anatomy vs. pathology. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Visualizing, diagnosing, and documenting lumbar spine sequencing, disc herniations, neural canals, cauda equina, conus medullaris, nerve sleeves, canal stenosis grading, and vertebral width vs. height in determining segmental remodeling. Diagnosing thecal sac abutment, central canal root compression and ligamentum flava involvement. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Case study visualizing, diagnosing, and documenting cervical spine sequencing, disc herniations, neural canals, cauda equina, conus medullaris, and vertebral width vs. height in determining segmental remodeling. Identifying the Pons, Occipital junction, and spinal cord to identify Chiari 1 malformations. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Visualizing, diagnosing, and documenting lumbar spine sequencing, disc extrusion type herniations, neural canals, cauda equina, conus medullaris, spondylolisthesis, degenerative spondylolisthesis, disc degeneration, neural canal and central root compressions, central canal stenosis. Varices vs. herniations, and multiple level disc pathology with biomechanical failures. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Visualizing, diagnosing, and documenting cervical spine sequencing, disc extrusion type herniations, neural canals, disc degeneration, thecal sac compression, central canal stenosis, cord displacement, reversal of cervical curve, Chiari 1 malformation. Identifying spinal biomechanical failure in MRI sequencing, with visualizing ligamentous pathology as cause for failure. Differentially diagnosing recent vs. older trauma based upon edematous signal in T1, T2, and STIR images. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Visualizing, diagnosing, and documenting cervical spine sequencing, multiple disc extrusion type herniations, vertebral remodeling, intradural tumor displacing the spinal cord visualized in T1, T2, and STIR sequences, neural canal stenosis, disc degeneration, thecal sac compression, central canal stenosis, cord displacement, reversal of cervical curve, Chiari 1 malformation, and identifying of inferior brain structures. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Visualizing, diagnosing, and documenting 1) improper sequence acquisitions invalidating interpretation 2) incomplete study invalidating interpretation 3) visualizing, diagnosing, and documenting lumbar spine sequencing, multiple disc extrusion type herniations, vertebral remodeling, multiple thecal sac compressions, neural canal stenosis, disc osteophyte/ridging complex, central canal stenosis, spondylolisthesis. Identifying the spleen, liver, kidneys, inferior vena cava, and psoas musculature on imaging. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Visualizing, diagnosing, and documenting cervical spine sequencing, cervical spondylosis, pathological spinal biomechanics, reversal of lordotic curve, and vertebral width vs. height in determining segmental remodeling, central herniation, thecal sac compression of the cord, identifying tongue, epiglottis, hyoid cartilage, pharynx, thyroid. Reviewing fat saturation sequences for osseous metastatic tumors and advanced degeneration. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Visualizing, diagnosing, and documenting lumbar spine sequencing, degenerative disc disease, nerve root sleeve abutment, far lateral herniations vs. bulges, normal vs. dissected inferior vena cava aneurism, epidural fat as a space occupying lesion, facet arthropathy and edema, hypertrophy of ligamentum flava, and pseudo disc at the S1-S2 level. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
MRI Spine Clinical Grand Rounds, Visualizing, diagnosing, and documenting cervical spine sequencing utilizing T1 weighted images for pathology, inclusive of advanced degeneration and tumor detection. STIR in a fat saturated image for ligamentous pathology inclusive of the posterior longitudinal, ligamentous flava and interspinal ligaments. Normal clivus and odontoid for cerebellar tonsil location. Cerebral spinal fluid (CSF) flow and the utilization of the spinal cord’s central canal for CSF transport. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Shoulder, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures. Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Shoulder, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Elbow, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Wrist, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Hand, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Hip, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures. Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Hip, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Knee, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures. Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Knee, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Hand, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Extremity MRI & Xray Interpretation of the Foot, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Case Management, Spinal MRI and Documentation Documenting Herniated Discs, Age-Dating Disc Pathology, and Connective Tissue Pathology as Sequella to Trauma , Herniated Discs and Connective Tissue Pathology, differentially diagnosing herniated discs vs. normal and bulging discs and protruded, extruded and fragmented discs. Normal vs. Pathological connective tissues and age-dating herniated discs. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Case Management, Spinal MRI and Documentation, Case Management of Traumatic Spinal Injuries, Understanding flexion-extension cervical injures and diagnosing connective tissue pathology. Determining impairments and the literature-based standard for permanent injuries. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Case Management, Spinal MRI and Documentation, Managing Herniated and Bulging Discs, Serious Injury in Non-Herniated Cases from Trauma, Spinal disc morphology, and innervation. Herniated, bulged, protruded, and sequestered disc characteristics and management. Literature-based documentation requirements for no-dis spinal injuries. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Case Management, Spinal MRI and Documentation, Herniated Discs and Permanent Brain Malfunction & Biomechanical Failure, A case-study of a post-traumatic herniated disc and related brain malfunction supported by contemporary literature, MRI acquisition, and necessity protocols. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Case Management, Spinal MRI and Documentation, Demonstrative Documentation of Disc Herniationand MRI Physics, Understanding the documentation requirements to demonstratively show spinal disc lesions in reporting pathology. Understanding the physics of a nucleus resonating in T1 and T2 weighted imagery. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Case Management, Spinal MRI and Documentation, Post-Traumatic Herniated Discs, Related Migraines-Headaches & Strain/Sprain Permanences, Relationship of headaches, and migraines to cervical spine disc herniation, clinical rationale for ordering MRI’s and the relationship of ligamentous pathology to spinal trauma. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Case Management, Spinal MRI and Documentation, Documentation of Low-Speed Crashes in Determining Etiology of Serious Bodily Injuries, Documentation requirements during the evaluation, and management encounter to understand the etiology of spinal injuries. Having a complete understanding the forces involved to conclude a differential diagnosis, while concurrent ruling malingerers, if applicable. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Trends in Spinal Healthcare, Analyzing spinal healthcare trends in both utilization and necessity and understanding the marketplace and how a clinical excellence level is reflected in a doctors' documentation and credentials. Treatment pathways in triaging spinal pathobiomechanics. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
MRI Spine Interpretation Advanced Diagnosis, An evidence-based understanding of time-related etiology of disc pathology considering the American Society of Neuroradiology's designation of protrusion, extrusion, and sequestration of spinal discs, T1, T2, STIR and Proton-Density weighted evaluation to diagnose spine form MRI accurately. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
Spinal Biomechanical Engineering Analytics and Case Management, Utilizing spinal mensurating algorithms to conclude a pathobiomechanical vs. normal spine in the absence of anatomical pathology. Clinically correlating a history and physical examination findings to x-ray biomechanical results in creating an accurate diagnosis, prognosis, and treatment plan. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
MSK Extremity Radiological Interpretation, Utilizing both MRI and x-ray to diagnose 1) Arthritis - Inflammatory and Degenerative, 2) Advanced cartilage assessment, 3) Rotator Cuff Tears, 4) Labral tears (shoulder and hip), 5) Tendon injuries and degeneration, 6) Meniscal tears, 7) Ligamentous injuries, 8) Common fractures, 9) Sports-related injury patterns, 10) Plantar fasciitis.Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
Demonstrative Medical-Legal Documentation, The narrative report. How to effectively create medical-legal documentation and what the courts look for. Making your "4-Corner" (narrative) report demonstrable and build a reputation as an evidence-based provider. The step-by-step minutiae of building a report.Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
Managing Non-Anatomical Spine Pain, Treatment modalities centered upon "best-outcomes" in an evidence-based model considering chiropractic vs. physical therapy and chiropractic vs. medicine. Considerations of disability, pain reduction, functional improvement, drugs utilized, and side-effects are all considered. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2021
Documentation and Coding, CPT Coding Guidelines for Initial and Established Patients with particular attention paid to Patient History, Review of Systems, Social and Family History, Physical Examination, and Medical Decision making. Specific differences in coding levels and required elements for a 99202-99203-99204-99205, and a 99212-99213-99214-99215. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University- Kansas City, Long Island, NY, 2021
Demonstrative Documentation and Ethical Relationships, Pathways to improve coordination of care, and interprofessional communication with collaborating physicians. Maintaining ethical relationships in the medical-legal community through documentation and communication of demonstrable diagnosis, prognosis, and treatment plans. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University- Kansas City, Long Island, NY, 2021
MRI Spine Interpretation, Clinical case review of MRI’s including sagittal, axial, T1, T2, STIR, and proton density sequences. Identified will be the vertebrate, spinal cord, discs, nerve roots, thecal sac, posterior longitudinal ligament, epidural veins, and fat saturation pulses. Pathology will include bulges, herniations, protrusions, extrusions, myelomalacia, cord edema, and schmorl’s nodes. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University- Kansas City, Long Island, NY, 2021
Spinal Biomechanical Engineering Clinical Grand Rounds, Case reviews utilizing E/M, MRI, and x-ray mensuration report to conclude an accurate diagnosis, prognosis, and treatment plan. Common diagnosis requiring interprofessional collaboration with a discussion of diagnostic dilemmas and proper communication methods. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University- Kansas City, Long Island, NY, 2021
Demonstrative Diagnosis and Documenting Spinal Pathology, Analyzing patient records, x-rays and MRI’s in determining etiology of traumatically-induced pathological lesions. Clinically correlating the history, clinical findings, imaging findings and diagnosed bodily injuries to conclude and accurate diagnosis, prognosis, and treatment plan. Cleveland University - Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Demonstrative Diagnosis and Documenting Spinal Disc Injuries, Differentially diagnosing disc vs. posterior longitudinal ligaments vs. Thecal Sac vs. spinal cord vs. Ligamentum Flava pathology and insult. Identifying the borders of lesions and discerning between anatomic structures pathologically effected demonstrably. Cleveland University - Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021
Documentation, MRI Necessity and Trends in Spinal Treatment Protocols, Correlating history and a thorough clinical evaluation in determining the necessity for x-ray and MRI evaluations in the trauma and non-trauma patient. Considering whole spine patho-biomechanics in formulating treatment plans and long-term supportive care. Documentation requirements in transitioning from telemedicine to in-office care. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing boards, Cleveland University Kansas City, Long Island, NY, 2021
Pathobiomechanics and Documentation, CPT Coding Guidelines for Initial and Established Patients with particular attention paid to Patient History, Review of Systems, Social and Family History, Physical Examination, and Medical Decision making. Specific differences in coding levels and required elements for a 99202-99203-99204-99205. Academy of Chiropractic Post-Doctoral Division, Cleveland University Kansas City, Long Island, NY, 2020
Using Documentation and Ethical Relationships, Pathways to improve coordination of care, and interprofessional communication with collaborating physicians. Maintaining ethical relationships in the medical-legal community through documentation and communication of demonstrable diagnosis, prognosis and treatment plans. Academy of Chiropractic Post-Doctoral Division, Cleveland University Kansas City, Long Island, NY, 2020
Spinal Biomechanical Engineering Clinical Application, History of clinical biomechanics with an emphasis on the diagnosis and management of spine pain of mechanical/functional origin. Evidence-based symptomatic vs. asymptomatic parameters using peer-reviewed medical index literature. Computerized mensuration analysis of spinal biomechanical pathology. Comparison of demonstrable spinal biomechanical failure on imaging to clinical evaluation and physical examination. Academy of Chiropractic Post-Doctoral Division, Cleveland University Kansas City, Long Island, NY, 2020
Spinal Biomechanical Engineering Clinical Grand Rounds, Case reviews utilizing E/M, MRI, and x-ray mensuration report to conclude an accurate diagnosis, prognosis, and treatment plan. Common diagnosis requiring interprofessional collaboration with a discussion of diagnostic dilemmas and proper communication methods. Academy of Chiropractic Post-Doctoral Division, Cleveland University Kansas City, Long Island, NY, 2020
Diagnosing and Case Management, The requirements for diagnosing based upon in an initial evaluation and management encounter ranging from a 99202 – 99205 that includes comorbidities, non-musculoskeletal, and sequellae to injury diagnosis. Academy of Chiropractic Post-Doctoral Division, Cleveland University - Kansas City, Long Island, NY , 2020
Diagnosing and Case Management, The requirements for diagnosing imaging inclusive of static x-rays, biomechanical x-rays, and MRI. Documenting the clinical findings of disc bulge, herniation, protrusion, extrusion, and fragmentation. Coding, diagnosing, and documenting individual treatment encounters in the clinical setting. Academy of Chiropractic Post-Doctoral Division, Cleveland University - Kansas City, Long Island, NY , 2020
Trends in Spinal Treatment, Management of spinal care for mechanical spine issues from hospitals and medical specialists to trauma qualified chiropractors based upon published outcomes. Utilizing imaging studies in spinal biomechanics, pain models, and clinical outcomes to determine a conclusive diagnosis, prognosis, and treatment plan for triaging in a collaborative environment. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Neurology of Spinal Biomechanics, Understanding spinal biomechanics, and the neurotransmitters required for homeostasis. The interconnected role of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioreceptors, and Mechancoreceptors in maintaining sagittal and axial alignment in the presence of mechanical pathology. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
MRI Age-Dating of Herniated Discs, The literature, academic and clinical standards to age-date herniated discs. The clinical correlation of the pain patterns with advanced imaging finings of bone edema, and bone spurs based upon the Piezoelectric effect for remodeling, high signal on T2 weighted images, Vacuum Discs, and disc heights in determining the time frames of the etiology of spinal disc pathology. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Creating Ethical Collaborative and Medical-Legal Relationships, Understanding the timely triage necessities based upon clinical and imaging outcomes, and the documentation required for collaborative physicians to continue care. Ensuring that the documentation is complete, reflective of services rendered, and clear for third party consideration in an admissible format to be considered in a medical-legal environment. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Central Innervation of Spinal Biomecinacal Engineering, Understanding the lateral and ventral horn’s innovations of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioreceptors and Mechancoreceptors, and the pathways through the spinal thalamic tracts through the periaqueductal region, the Thalamus into the Occipital, pre-frontal, sensory and motor cortexes and then efferently back through the Thalamus to disparate regions in creating spinal homeostasis. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Identifying Spinal Pathology of MRI, Utilizing T1, T2, STIR, and Gradient studies in determining myelomalacia, intra and extra-dural tumors, and systemic disease patterns affecting the spinal cord. When to use contrast post-operatively in identifying discal structures vs. adhesions in postoperative advanced imaging. MRI Interpretation of herniated, circumferential bulges, focal bulges, protruded, extruded, comminuted, sequestered, and fragmented discs. When to consider a neurosurgical consultation based upon the correlation of imaging and clinical findings. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Documentation, Carrier Mandates and How the Guide ER and Lawyer Referrals, Documenting electrodiagnostics, concussion and disc pathology as reflective of clinical findings when collaborating with medical specialists in private practice and hospital settings or in the medical-legal arena. Ensuring complete documentation in the evaluation and management process for both the initial and re-evaluation processes. Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Accident Reconstruction: Terms, Concepts and Definitions, The forces in physics that prevail in accidents to cause bodily injury. Quantifying the force coefficients of vehicle mass and force vectors that can be translated to the occupant and subsequently cause serious injury. Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Accident Reconstruction: Causality, Bodily Injury, Negative Acceleration Forces, Crumple Zones and Critical Documentation, Factors that cause negative acceleration to zero and the subsequent forces created for the vehicle that get translated to the occupant. Understanding critical documentation of hospitals, ambulance reports, doctors and the legal profession in reconstructing an accident. Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Accident Reconstruction: Skid Marks, Time, Distance, Velocity, Speed Formulas and Road Surfaces, The mathematical calculations necessary utilizing time, distance, speed, coefficients of friction and acceleration in reconstructing an accident. The application of the critical documentation acquired from an accident site. Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Accident Reconstruction: Research, Causality and Bodily Injury, Delta V issues correlated to injury and mortality, side impact crashes and severity of injuries, event data recorder reports correlated to injury, frontal impact kinematics, crash injury metrics with many variables and inquiries related to head restraints.Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019
Stroke Anatomy and Physiology: Brain Vascular Anatomy, The anatomy and physiology of the brain and how blood perfusion effects brain function. A detailed analysis of the blood supply to the brain and the physiology of ischemia. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Stroke Anatomy and Physiology: Stroke Types and Blood Flow, Various types of stroke identifying ischemia, hypoperfusion, infarct and penumbra zones and emboli. Cardiac etiologies and clinical features as precursor to stroke with associated paradoxical emboli and thrombotic etiologies. Historical and co-morbidities that have etiology instroke inclusive of diabetes, coagulopathy, acquired and hereditary deficiencies. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Stroke Principles of Treatment an Overview for the Primary Care Provider, Stroke type and treatments performed by vascular specialists. The goals of treatment with the physiology of the infarct and penumbra zones and the role of immediate triage in the primary care setting. Detailing the complications of stroke and future care in the chiropractic, primary care or manual medicine clinical setting. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Clinical Evaluation and Protocols for Identifying Stroke Risk, The neurological history and examination for identifying stroke risks with a focus on supra and infratentorial regions, upper and lower motor lesions, cranial nerve signs, spinal cord pathology, motor and sensory pathology and gait abnormalities. Examining genetic and family histories along with dissection risk factors. Stroke orthopedic testing and clinical guidelines pertaining to triage for the primary care provider.Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Spinal Trauma Pathology, Triage and Connective Tissue Injuries and Wound Repair, Triaging the injured and differentially diagnosing both the primary and secondary complaints. Connective tissue injuries and wound repair morphology focusing on the aberrant tissue replacement and permanency prognosis potential. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2019
Spinal Trauma Pathology, Ligament Anatomy and Injury Research and Spinal Kinematics, Spinal ligamentous anatomy and research focusing on wound repair, future negative sequelae of abnormal tissue replacement and the resultant aberrant kinematics and spinal biomechanics of the spine. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2019
Spinal Trauma Pathology, Spinal Biomechanics, Central Nervous System and Spinal Disc Nomenclature, The application of spinal biomechanical engineering models in trauma and the negative sequelae it has on the central nervous system inclusive of the lateral horn, periaqueductal grey matter, thalamus and cortices involvement. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2019
Spinal Trauma Pathology, Biomechanics of Traumatic Disc Bulge and Age Dating Herniated Disc Pathology, The biomechanics of traumatic disc bulges as sequelae from trauma and the comorbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2019
Spinal Trauma Pathology, Clinical Grand Rounds, The review of case histories of mechanical spine pathology and biomechanical failures inclusive of case histories, clinical findings and x-ray and advanced imaging studies. Assessing comorbidities in the triage and prognosis of the injured. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2019
Spinal Trauma Pathology, Research Perspectives, The review of current literature standards in spinal trauma pathology and documentation review of biomechanical failure, ligamentous failure and age-dating disc pathology. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2019
Spinal Biomechanical Engineering: Cartesian System, The Cartesian Coordinate System from the history to the application in the human body. Explanation of the x, y and z axes in both translation and rotations (thetas) and how they are applicable to human biomechanics. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Spinal Biomechanical Engineering: Cervical Pathobiomechanics, Spinal biomechanical engineering of the cervical and upper thoracic spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Spinal Biomechanical Engineering: Lumbar Pathobiomechanics, Spinal biomechanical engineering of the lumbar spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Spinal Biomechanics in Trauma, To utilize whiplash associated disorders in various vectors of impact and whiplash mechanisms in determining pathobiomechanics. To clinically correlate annular tears, disc herniations, fractures, ligament pathology and spinal segmental instability as sequellae to pathobiomechanics from trauma. The utilization of digital motion x-ray in diagnoising normal versus abnormal facet motion along with case studies to understand the clinical application. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Spinal Biomechanical Engineering & Organizational Analysis, Integrating spinal biomechanics and pathobiomechanics through digitized analysis.The comparison of organized versus disorganized compensation with regional and global compensation. Correlation of the vestibular, occular and proprioceptive neurological integration in the righting reflex as evidenced in imaging. Digital and numerical algorithm in analyzing a spine. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Spinal Biomechanical Engineering: Cervical Digital Analysis, Digitizing and analyzing the cervical spine in neutral, flexion and extension views to diagnose pathobiomechanics. This includes alteration of motion segment integrity (AMOSI) in both angular and translational movement. Ligament instability/failure/pathology are identified all using numerical values and models. Review of case studies to analyze pathobiomechanics using a computerized/numerical algorithm. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Spinal Biomechanical Engineering: Lumbar Digital Analysis, Digitalizing and analyzing the lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Spinal Biomechanical Engineering: Full Spine Digital Analysis, Digitalizing and analyzing the full spine images to diagnose pathobiomechanics as sequellae to trauma in relation to ligamentous failure and disc and vertebral pathology as sequellae. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Orthopedic Testing: Principles, Clinical Application and Triage, Integration of orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Orthopedic Testing: Cervical Spine, Integration of cervical orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Orthopedic Testing: Cervical Spine, Integration of cervical orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Orthopedic Testing: Lumbar Spine, Integration of lumbar orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Orthopedic Testing: Clinical Grand Rounds, how to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Impairment Rating, The understanding and utilization of the protocols and parameters of the AMA Guide to the Evaluation of Permanent Impairment 6th Edition. Spine, neurological sequelae, migraine, sexual dysfunction, sleep and arousal disorders, station and gait disorders and consciousness are detailed for impairment rating. Herniated discs, radiculopathy, fracture, dislocation and functional loss are also detailed in relation to impairment ratings. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2018
Primary Spine Care 2: Spinal Trauma Pathology, Morphology of healthy and traumatized connective tissue and the permanency implication of adhesions, spinal disc morphology in the healthy and pathological patient as sequella to trauma in relationship to bulges, herniations, protrusions, extrusions and sequestrations. Aberrant spinal biomechanics and negative sequella to trauma. Cleveland University – Kansas City, Academy of Chiropractic, Setauket NY, 2017
Primary Spine Care 2: Utilizing Research in Trauma, The ability of your electronic health records to convey tissue pathology while documenting case studies, field experiments, randomized trials and systematic literature reviews, Introducing evidence based macros in documentation to support the literature and necessity of care. Cleveland University – Kansas City, Academy of Chiropractic, Setauket NY, 2017
Primary Spine Care 2: Chiropractic Evidence, Analyzing segmental pathology, adjusting vs. mobilization with cervicogenic headaches, Opioid alternatives and case management of mechanical spine pain based upon outcome studies. Cleveland University – Kansas City, Academy of Chiropractic, Setauket NY, 2017
Primary Spine Care 2: Chiropractic Spinal Adjustment Central Nervous System Processing, Literature reviews of mechanoreceptor, proprioceptor and nociceptor stimulation of later horn gray matter with periaqueductal stimulation affecting the thalamus and cortical regions with efferent distribution in disparate regions of the body in both pain and systemic stimulation. Cleveland University – Kansas City, Academy of Chiropractic, Setauket NY, 2017
Primary Spine Care - Credentials and Knowledge Base, The credentials and knowledge based from an academia perspective when cooperatively treating in a collaborative environment inclusive of understanding pathology and mechanical spine issues. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017
Primary Spine Care - Spinal Biomechanical Engineering and MRI Spine Interpretation, Integrating Spinal Biomechanical Engineering and MRI Spine Interpretation into a primary spine care model, inclusive of necessity and acquisition protocols. A comprehensive review the latest evidence in documenting mechanical issues. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017
Primary Spine Care - Hospital Administration, Triage, Clinical Requirements and Collaborative Relationships with Medical Specialists, Understanding hospital and medical specialist’s care paths for mechanical spine pathology and integrating the doctor of chiropractic in the hospital and allopathic treatment protocols. Cleveland University - Kansas City, Long Island, NY, 2017
Primary Spine Care - Contemporary Spine Research and Documentation, Central nervous system connection and the thalamus, hypothalamus connection in both ascending and descending central pathways with neuro-endocrine implications that have the mechanisms to be a component of Schizophrenia, Dementia and Alzheimer's with a linear relationship to the chiropractic spinal adjustment and chronic pain. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017
Mastering Brain Chemistry, This course reviews the key concepts of brain chemistry, recognize patterns of imbalances, recognize cases that may need to be referred for further consult or evaluation, and improve overall clinical competency in neurochemical assessment. University of Bridgeport, Health Sciences, Postgraduate Education Department, College of Chiropractic, Bridgeport, CT, 2017
Professional Boundaries, This course provided discussions regarding Professional Boundaries Define; the Basis for the Doctor/Patient Relationship, Transference/Countertransference, Terminology Associated with Sexual Misconduct, Boundary Violation vs. Boundary Crossing, Case Studies, Doctor Profiles, Caution Signs, Guidelines for Prevention. Life University, Federation of Chiropractic Licensing Boards, Marietta, GA, 2017
Georgia Jurisprudence, The course provided current health care law within the state of Georgia as it pertains to Chiropractic Providers. Life University, Federation of Chiropractic Licensing Boards, Marietta, GA, 2017
Chiropractic Ethics, This course discussed personal, business, and professional ethics as they relate to chiropractic. A review of the American Chiropractic Association’s and International Chiropractic Association’s Code of Ethics was detailed. This course also discussed, in detail the Informed Consent Doctrine and the difference between an independent contractor and an employee. Life University, Federation of Chiropractic Licensing Boards, Marietta, GA, 2017
Basic Case Management, This course provided the basic principles of case management. It included discussion on evaluation, diagnosis, setting goals, treatments and outcome assessments. Life University, Federation of Chiropractic Licensing Boards, Marietta, GA, 2017
MRI History and Physics, Magnetic fields, T1 and T2 relaxations, nuclear spins, phase encoding, spin echo, T1 and T2 contrast, magnetic properties of metals and the historical perspective of the creation of NMR and MRI. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Spinal Anatomy and Protocols, Normal anatomy of axial and sagittal views utilizing T1, T2, 3D gradient and STIR sequences of imaging. Standardized and desired protocols in views and sequencing of MRI examination to create an accurate diagnosis in MRI. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Disc Pathology and Spinal Stenosis, MRI interpretation of bulged, herniated, protruded, extruded, sequestered and fragmented disc pathologies in etiology and neurological sequelae in relationship to the spinal cord and spinal nerve roots. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Spinal Pathology, MRI interpretation of bone, intradural, extradural, cord and neural sleeve lesions. Tuberculosis, drop lesions, metastasis, ependymoma, schwanoma and numerous other spinal related tumors and lesions. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Methodology of Analysis, MRI interpretation sequencing of the cervical, thoracic and lumbar spine inclusive of T1, T2, STIR and 3D gradient studies to ensure the accurate diagnosis of the region visualized. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Methodology of Analysis, MRI interpretation sequencing of the cervical, thoracic and lumbar spine inclusive of T1, T2, STIR and 3D gradient studies to ensure the accurate diagnosis of the region visualized. ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences Jacobs Buffalo, NY, 2016
MRI Clinical Application, The clinical application of the results of space occupying lesions. Disc and tumor pathologies and the clinical indications of manual and adjustive therapies in the patient with spinal nerve root and spinal cord insult as sequelae. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Protocols Clinical Necessity, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images. Clinical indication for the utilization of MRI and pathologies of disc in both trauma and non-trauma sequellae, including bulge, herniation, protrusion, extrusion and sequestration. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Interpretation of Lumbar Degeneration/Bulges, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl/'s nodes and herniations. Central canal and cauda equina compromise interpretation with management. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Interpretation of Lumbar Herniations, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl/'s nodes and herniations. Morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Central canal and cauda equina compromise interpretation with management. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Interpretation of Cervical Degeneration/Bulges, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of cervical degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl/'s nodes and herniations. Spinal cord and canal compromise interpretation with management. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Interpretation of Cervical Herniations, MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl/'s nodes and herniations. morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Spinal cord and canal compromise interpretation with management. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
MRI Interpretation of Degenerative Spine and Disc Disease with Overlapping Traumatic Insult to Both Spine and Disc, MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of degenerative spondylolesthesis, spinal canal stenosis, Modic type 3 changes, central herniations, extrusions, compressions, nerve root compressions, advanced spurring and thecal sac involvement from an orthopedic, emergency room, chiropractic, neurological, neurosurgical, physical medicine perspective. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016
Head Trauma, Brain Injury and Concussion, Brain and head physiology, brain mapping and pathology as a sequella to trauma. Traumatic brain injury, mild traumatic brain injury, axonal shearing, diffuse axonal injury and concussion are detailed in etiology and clinically. Clinical presentation, advanced diagnostic imaging and electrodiagnostics are detailed in analysis to create a differential diagnosis. Balance disorders that often occur as a result of trauma are also explored from clinical presentation to advanced imaging and differential diagnosis. Texas Chiropractic College, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2016
Neurodiagnostics, Imaging Protocols and Pathology of the Trauma Patient, An in-depth understanding of the protocols in triaging and reporting the clinical findings of the trauma patient. Maintaining ethical relationships with the medical-legal community. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2015
Diagnostics, Risk Factors, Clinical Presentation and Triaging the Trauma Patient, An extensive understanding of the injured with clinically coordinating the history, physical findings and when to integrate neurodiagnostics. An understanding on how to utilize emergency room records in creating an accurate diagnosis and the significance of "risk factors" in spinal injury. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2015
Crash Dynamics and Its Relationship to Causality, An extensive understanding of the physics involved in the transference of energy from the bullet car to the target car. This includes G's of force, newtons, gravity, energy, skid marks, crumple zones, spring factors, event data recorder and the graphing of the movement of the vehicle before, during and after the crash. Determining the clinical correlation of forces and bodily injury. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2015
MRI, Bone Scan and X-Ray Protocols, Physiology and Indications for the Trauma Patient, MRI interpretation, physiology, history and clinical indications, bone scan interpretation, physiology and clinical indications, x-ray clinical indications for the trauma patient. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2015
Neurodiagnostic Testing Protocols, Physiology and Indications for the Trauma Patient, Electromyography (EMG), Nerve Conduction Velocity (NCV), Somato Sensory Evoked Potential (SSEP), Visual Evoked Potential (VEP), Brain Stem Auditory Evoked Potential (BAER) and Visual-Electronystagmosgraphy (V-ENG) interpretation, protocols and clinical indications for the trauma patient. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2015
Documentation and Reporting for the Trauma Victim, Understanding the necessity for accurate documentation and diagnosis utilizing the ICD-9 and the CPT to accurately describe the injury through diagnosis. Understanding and utilizing state regulations on reimbursement issues pertaining to healthcare. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2015
Documenting Clinically Correlated Bodily Injury to Causality, Understanding the necessity for accurate documentation, diagnosis and clinical correlation to the injury when reporting injuries in the medical-legal community. Documenting the kinesiopathology, myopathology, neuropathology, and pathophysiology in both a functional and structural paradigm. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2015
Muscular Strength in Clinical Practice: Influence of Chiropractic, Assessment with Dynamometry, Training, Principles and Guidelines. University of Bridgeport, Health Sciences, Post Graduate Education Department, Bridgeport, CT, 2003
Cervical Spine and Biomechanics and Whiplash, Muscle Adaptation to Stretching, Manipulation and EMG. University of Bridgeport, Health Sciences, Post Graduate Education Department, Bridgeport, CT, 2003
SELECTED MEMEBERSHIPS
Integrative Pain Management, 2019 – Present
American Academy of Medical Legal Professionals, 2016 – Present
Academy of Chiropractic, 2015 – Present
US Chiropractic Directory, 2015 – Present
American Academy of Pain Management, 2015 – Present
Academy of Chiropractic Orthopedics, 2015 – Present
Georgia Chiropractic Association, 2008 – Present
Georgia Board of Chiropractic Examiners, 1988 – Present
National Board of Chiropractic Examiners, 1988 – Present
New Jersey Board of Chiropractic Examiners, 1987 - Present