Contributing Professional

Michael Kukys

Using Colorized Films to Add Value to Injury Cases

Black and white diagnostic (DICOM) films can be difficult to understand and may be missing the strength to communicate the seriousness of your client’s injury or condition clearly to the target audience (jurors). Medical illustrators combine art, forensics, anatomy, and knowledge of medicine to create accurately colorized diagnostic films so that jurors can understand exactly what they are looking at, as well as to draw attention to the specific area/s of your client’s injuries.

Medical illustrators combine art, forensics, anatomy, and knowledge of medicine to create accurately colorized diagnostic films so that jurors can understand exactly what they are looking at, as well as to draw attention to the specific area/s of your client’s injuries.

What is DICOM?

Most attorneys can think back to the first time a CD or DVD hit their desk and they tried to open it only to discover files they have never seen before, the notorious DICOM® (Digital Imaging and Communications in Medicine). A DICOM is simply the international standard to transmit, store, retrieve, print, process, and display medical imaging information. DICOM is used in virtually all hospitals worldwide. It ensures the interoperability of systems used to produce, store, display, send, query, process, retrieve and print medical images and derived structured documents, as well as to manage the related workflow.

DICOMs and X-rays

X-rays use a type of radiation called electromagnetic waves to identify changes in density in radiation absorption to create a picture of the inside of your body. The images show the parts of your body in different shades of black and white because different tissues absorb different amounts of radiation. The calcium in you bones absorbs x-rays the most, so bones look white. Fat and other soft tissues absorb less, and look gray. Air absorbs the least, so, for example, lungs look black.

DICOMs and CT Scans

A computed tomography (CT) test combines multiple x-ray images into a 3D model of a region of interest. So, it is basically several x-rays layered on each other. 

Why we use X-Ray colorizations in Injury Cases

With black and white x-rays, major injuries and the postoperative hardware can often be seen without color, but a lot can be missed and the injury may not be fully understood by the layperson. Oftentimes, untrained individuals struggle to interpret what they see and then must rely solely on testimony. However, when the x-rays or CT scans are colorized, the audience (jury, adjuster, defense counsel, mediator) can connect with what they are learning about and see and understand exactly what they are looking at. As a result, the impact of that evidence becomes significantly more powerful. The x-ray is essentially brought to life.  

Colorized Post-Op X-Rays

One of the most powerful ways we can tactically deploy colorized x-rays in litigation is using  post-op images to show repairs done. The radiation makes is possible to easily to tell the bone from any surgical hardware such as plates, rods and screws. Most audiences can easily see those. However, the use of color adds another depth to these and allows the audience to see the screws as metallic and the bone as a yellowish-gray shade of white, bringing it to life and usually invoking a reaction to the effect of “ouch, glad that’s not me.”

Pre- and post-op x-rays can even be used to show the extent of what was necessary to try to fix the client like in the images below. Who would question how painful that recovery was? 

Colorization of MRIs

As most lawyers know, after an accident or trauma, certain injuries will not show up on an x-ray that will show up on an MRI. While broken bones appear on x-rays, it is necessary to use an MRI to identify damage to muscles and soft tissue, which will appear on MRI studies.

What is an MRI?

By now, most injury lawyers know what an MRI is, but we will do a quick refresher nonetheless. Magnetic resonance imaging (MRI) is a noninvasive test used to diagnose medical conditions. MRI uses a powerful magnetic field, radio waves, and a computer to produce detailed pictures of internal body structures. MRI does not use radiation as opposed to x-rays which do. Detailed MRI images allow doctors to examine the body and detect disease or injuries.

MRI Films Can Also Be Colorized

MRI films can be colorized to show spinal disc bulges, protrusions, herniations and nerve root impingements which can be seen more clearly and impactfully by having color added to the original film. Colorized MRI films can distinctly show the detail of a client’s soft tissue injuries to an audience that may not entirely understand the black and white original film. Colorized MRI films illustrate the nature of a client’s soft tissue injuries and provide an instant visualization of seriousness of the injuries.

Attorneys can combine regular and colorized DICOM Images with Medical Illustrations to create powerful demonstrative exhibits

Although the colorization is powerful on its own, sometimes you want your expert to explain the process of how a surgery occurred or what the mechanism of injury was. In those cases, you can combine colorizations with medical illustrations and have extremely powerful exhibits. 

The value of Colorizations

Since the anatomy, injury, or postoperative condition is colorized directly over the original diagnostic film, they are easy for the expert to use in order to aid and assist their testimony and explain injuries to the jury. These are medically accurate and allows for a side by side comparison with the original diagnostic film. 

Film colorizations of a client’s DICOM films (X-rays, MRIs and CT Scans) are definitely something attorneys can use to enhance the value of their cases and are also one of the most affordable assets available on the market today. 

How Much Do Colorizations Cost? 

Total Trial Solutions charges a flat rate of only $375 per image to be colored. There are no hidden fees such as “set-up” or “management” fees that are added like many in the industry do – the price is the price – $375

If you want to learn more about the process or are interested in ordering colorizations of DICOM’s, you can to get started.

About the Author

Kichael Kukys Association of Medical Illustrators
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Michael is a highly talented medical illustrator who has spent his career at the intersection of art, medicine and the law. He is trained in human anatomy and physiology and he truly understands the significant impact his work has on client’s cases. He is a member of the Association of Medical Illustrators and is widely recognized in this industry for his superior artistic skill and in-depth knowledge of medicine. In his free time, Michael enjoys spending time with his wife and their two cats as well as gaming, enjoying metal music & concerts, anime, sci-fi movies & shows, photography, and traveling.