Sent to attorneys August 12, 2026.
A short note from my practice on something that comes up often in orthopaedic records review.
An MRI obtained within a few weeks of a soft tissue spine injury and an MRI obtained six months later are not interchangeable studies, and the difference matters whenever imaging is being used to support or contest causation. In the acute window, fluid-sensitive sequences (T2 and STIR) can show edema in paraspinal muscle, interspinous ligaments, facet capsules, or vertebral marrow, sometimes with small effusions or signal changes that indicate a recent injury. These acute findings tend to fade over weeks to a few months as the tissues heal, and by six months the same segment may read as “unremarkable” on a routine study while the patient still has real symptoms. A disc herniation itself also changes on imaging over time. Systematic reviews of the natural history of lumbar disc herniation report that spontaneous resorption most often occurs within roughly three to six months, with extrusions and sequestrations regressing more reliably than protrusions or bulges.
The practical consequence is that timing has to be part of the argument, not a footnote to it. An MRI performed four to six weeks after an event is the study most likely to capture acute markers that a late study may no longer show, and a normal late MRI does not by itself prove there was never an acute injury. On the other side, a chronic imaging appearance with disc desiccation, endplate osteophytes, and multilevel degenerative change does not, by itself, tell you whether a specific event aggravated a preexisting condition. Correlation with prior imaging, the documented symptom timeline, and the physical examination is what supports or weakens the inference. When only one MRI exists in a file, its date relative to the incident is one of the most important pieces of information in the record.
Educational only, not case-specific, and not legal or medical advice for any particular matter.
F. Allen Johnston, MD
Louisiana Orthopedic Institute
Baton Rouge
(225) 751-6666 Office
