Legal/Medical

Our diagnostic center is fully equipped to objectively document temporomandibular, craniomandibular, and cervical dysfunctions consequent to tissue injuries from head and neck trauma (i.e., whiplash episodes from motor vehicle accidents, industrial accident trauma, etc.).

The following is a list of available services for trauma victims, their insurers and attorneys:

 

COMPREHENSIVE NARRATIVES( IME, PPD):

These comprehensive reports would include a history of how the injury occurred, a description of the victim’s injuries and a diagnosis relative to his/her complaints, a review of the diagnostics relative to the treatment procedures undertaken, an outline of his/her treatment (current and projected), including probable costs, time/date referencing derived from tomograms identifying the nature, location, and amount of osteogenic degeneration (particularly important when determining pre?existing conditions), evidence of permanent tissue damage, current and projected physical impairment, prognosis, objective documentation confirming permanent injuries, forensic analysis relating the bio/physio/ mechanics to the injuries sustained in the trauma episode, etc., and, if appropriate, a review of vocational (job?related) dysfunctions.  Obviously, the amount and extent of our documentation and preparation is determined by the insurer’s or attorney’s assessment of individual case import and requirements.

RECORDS REVIEWS:

 

APPEARANCES:

I am available for depositions, hearings or court appearances. Attorneys may call me for further information and fees for such appearances.

DIAGNOSTICS:

Following is further information on the diagnostic procedures and other objective testing services available in my office, should you require them at any time:

These diagnostics may be used to document injuries to the soft and hard components of the temporomandibular joint and to document not only the craniomandibular dysfunction but also the concomitant neurovasomuscular and cervical dysfunctions.

HEAD & NECK SECTOGRAPHY: all varieties of head and neck x-rays, including sinus studies, cervical studies etc., all of which can be repeated in future with the patient in exactly the same position to determine changes occurring as a result of treatment, non-treatment, further trauma, etc.

TOMOGRAPHY: Tomography: provides clinicians with layered views, cuts or slices of anatomical structures. These underlying tissues are usually obscured when using conventional x-rays because of the superimposition of more superficial tissues. In addition, the advantage of a “corrected cut” is the accuracy of the subject anatomy, without artifacts, and its reproducibility before, during and after treatment.

TMJOINT TOMOGRAPHY yields a tremendous amount of even subclinical information about the fossa/condylar relationship and the integrity of the TMJoint mechanism.  Although soft tissues cannot be seen on tomograms, observing the relationship of the bony condyles and bony fossae in the open and closed positions provides a wealth of information on the integrity of the soft tissues intrinsic to the temporomandibular joints.

CORONAL TOMOGRAPHIC TRAUMA SERIES: This series of six coronal tomograms was developed by Dr. Terrence O’ Shaughnessy to ascertain changes in the density profile of the condylar head at each site of soft tissue attachment to the mandibular condyle, thus irrefutably referencing the presence or absence of trauma-induced tissue injury. For additional information, see Imagery.

ELECTRONIC BIO-INSTRUMENTATION TO OBJECTIVELY DOCUMENT COMPROMISED TMJOINT FUNCTION (DYSFUNCTION):

This essential diagnostic protocol provides the clinician with a wealth of information as to the nature of the dysfunction in the temporomandibular joint.  Obviously this information is extremely helpful in determining not only how to treat the dysfunctional joint, but gives the clinician an insight into limitations of treatment.

MOST OF OUR STUDIES INTEGRATE ANY OR ALL OF THE ABOVE.

For your information, in addition to providing accurate data for development of a comprehensive treatment plan, we can provide you with hard copy OBJECTIVE DOCUMENTATION of the victim’s injuries. This objective documentation confirming and re-confirming any existing injuries serves to document not only the craniomandibular dysfunction but also the concomitant neurovasomuscular and cervical dysfunctions from which the patient is suffering.

We are also able to objectively document permanent injuries utilizing these integrated diagnostic tests and studies. Obviously, this forensic analysis and objective documentation is more effective than any subjective opinion (without confirming documentation) usually provided by other clinicians, including independent medical examiners.

FUNCTIONAL STUDIES. Studies may be designed to simulate job categories or environs to determine special disability/impairment specific to the particular vocation of the victim.

When these “state of the art” OBJECTIVE DOCUMENTATIONS are utilized, aggressive settlements may be negotiated during litigation rather than proceeding to trial..

These same objective functional tests also give the treating doctor an insight into the limitations of tentative treatment plans before they are initiated.

 

State of the Art Office

We are now located at:

3660 Waialae Avenue, Suite 212
Honolulu, Hawaii 96816