title: [Problems involved in expert opinions on acceleration injuries of the cervical spine].
abstract: Reasons for problems in stating an expert opinion on acceleration injuries of the cervical spine are numerous. The presence of unexpected or the absence of expected symptoms, the lack of objective proof for alterations or the presence of complaints that are difficult to prove, the discrepancy between recognizable force of the impact versus the resulting damage to the injured as well as the chance of being completely incapable of rendering proof that unquestionably a potentially damage-causing event is--beyond any reasonable doubt--the origin of an observed alteration in an injured individual are some of the problems a medical expert has to face when dealing with the analysis of injuries of the cervical spine. Unsatisfactory documentation in the patient's records, discussions about the reliability of diagnostic means or the interpretation of their results, difficult to procure evidence of accident-specific biomechanics and their direct or indirect impact on the body or neck of the injured person as well as distinguishing cervical sprain from mild brain damage, post-traumatic distress syndrome, cognitive disorder, psychiatric disease, aggravation, or malingering makes it hard for an expert to state an expert opinion.
authors.affiliation: Zentrum für spezielle Chirurgie des Bewegungsapparates, Klinik für Unfall- und Wiederherstellungschirurgie, Campus Benjamin Franklin, Charité, Universitätsmedizin, Berlin. werner.wyrwich@charite.de
authors.forename: W
authors.initials: W
authors.lastname: Wyrwich
authors.forename: C E
authors.initials: CE
authors.lastname: Heyde
mesh_terms: D000054:Acceleration; D001696:Biomechanical Phenomena; D003937:Diagnosis, Differential; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D005858:Germany; D006801:Humans; D008306:Malingering / Q000175:diagnosis; D015995:Prevalence; D011859:Radiography; D012959:Socioeconomic Factors; D014911:Whiplash Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology