Are These Radiological Films or Modern Art?
Our team of medical illustrators confronts poor radiological films frequently. When a film study reveals grainy images and hard to decipher pathology, it’s time for a few deep breaths and a fresh cup of coffee (or three). Films are the foundation to the illustrations that we as medical illustrators create. It becomes difficult to render anatomically correct illustrations when the radiological images are not clear.
Unfortunately, we can’t do much about the poor quality of the images. The cases our firm takes on can be several years old, making it impossible to retake post-accident films. The patient has most likely healed, underwent surgery, or developed new symptoms by the time their attorney commissions us to create medical illustrations. So what do we do when dealing with bad radiological films? Below are three steps we work through to tackle inadequate films in a med-legal case:
Reference Other Images
In the best-case scenario, our client has sent over multiple radiological studies with a few up-to-par films. It is not uncommon that a client requests illustrations or radiological enlargements from a specific angle of which has unsavory radiological films. We may suggest using another study showing the injury from a different view that highlights it more distinctly. If the films are only moderately blurred, we can adjust the layout to include illustrations or enlargements from a secondary angle with clearer images to ensure anatomical accuracy.
Reference the Reports
It is always imperative to refer to the reports that correspond with radiological films. At Anatomical Justice, we utilize not only the radiology reports and testifying expert’s narrative, but our vast knowledge of anatomy to veraciously reproduce the pathology seen on the film.
Even as experts, it is easy to misinterpret the shapes and values of the anatomy if we review only the films. Reports can provide written clarification for films that may be less detailed than we would like when illustrating intricate body parts. If possible, we request the narrative report for the case in addition to radiological films and operative reports. Narrative reports are especially helpful in spinal cases where it may be hard to differentiate between a disc herniation and disc bulge. The expert medical witness ultimately has final say on the accuracy of the illustrations sent to our clients, so obtaining a copy of their report for reference on a poor quality film is a helpful tool.
If All Else Fails: Talk to the Client
As medical illustrators, we have a duty to ensure that each illustration accurately represents the anatomy of the individual from the case. If there is no way to ensure that our illustrations depict the pathology precisely due to poor radiological film quality, our team will reach out to the client.
Depending on external factors like timeframe, the number of images taken in the film study, and how long ago the injury/ surgery occurred, the attorney may be able to obtain film studies previously taken, but not submitted to us, or have their client go in for additional radiological imaging. If all else fails, options such as stock exhibits that show a generalized injury may be better suited to the case. As with all cases, our illustrators are always happy to evaluate your radiological films to determine the best course of action.
About the Author:
Ronald Mathias, CMI, is the Founder and Managing Member of Anatomical Justice, LLC. He has been immersed in medical media production and visual translation for the past twenty-five years. During that time, he has created thousands of innovative demonstrative aids for personal injury, medical malpractice and product liability cases for plaintiff and defendant attorneys across the US. His work has also included artwork for medical textbooks, journals, medical device advertising, comic books, and storyboarding for film.