Turn Stress View X-Rays Into Professional, Biomechanical AOMSI Reports.

DICOMetrics™ simplifies the entire CRMA process—from DICOM X-rays to a finished professional report. Upload your images, follow the intuitive workflow to complete the analysis, and DICOMetrics automatically performs the calculations and organizes the results into clear, standardized documentation.The platform is designed to be easy to use, with step-by-step tutorials available throughout the process. And if you ever need assistance, our technical support team is available to help.You perform the analysis. DICOMetrics™ handles the measurements, calculations, and documentation.

Yes. A physician's professional work in performing radiographic mensuration, interpreting the measurements, and preparing a documented CRMA/AOMSI analysis is a billable professional service.DICOMetrics™ provides the measurement and reporting tools used by the physician to perform and document the analysis; it does not bill the patient or payer on the physician's behalf. Appropriate coding, fees, documentation requirements, and reimbursement may vary by payer, jurisdiction, and the circumstances of the case.Physicians should select the CPT and diagnosis codes that most accurately represent the services they personally performed and verify applicable payer requirements. As with any medical service, billable does not mean reimbursement is guaranteed.DICOMetrics™ provides subscribers with billing and documentation support resources to assist practices in appropriately documenting these services.

Computerized Radiographic Mensuration Analysis (CRMA) is a method of measuring spinal motion on flexion, extension, and neutral lateral X-rays. It evaluates the movement between individual vertebrae to identify excessive translation or angulation that may indicate spinal ligament instability. The measurements and findings can then be incorporated into a physician’s clinical assessment and narrative report.

Alteration of Motion Segment Integrity (AOMSI) refers to excessive translation or abnormal angular motion between adjacent vertebrae, indicating instability of a spinal motion segment. It is evaluated by measuring vertebral movement on flexion and extension (stress view) X-rays and comparing the results with established criteria. AOMSI may be associated with spinal ligament injury and can be considered by a qualified physician as part of the patient’s clinical evaluation, diagnosis, and impairment assessment.

DICOMetrics™ requires original DICOM-format radiographs (.dcm) to ensure accurate measurement calibration using the imaging metadata contained within each file.For cervical, thoracic, and lumbar spinal motion analysis:Neutral lateral viewFlexion lateral viewExtension lateral viewFor upper cervical analysis:Neutral AP open-mouth viewRight lateral-bending AP open-mouth viewLeft lateral-bending AP open-mouth viewJPEG, PNG, screenshots, and other non-DICOM images are not supported because they do not contain the DICOM metadata required by DICOMetrics for reliable measurement calibration.

DICOMetrics™ does not accept video files generated by fluoroscopy, Digital Motion X-ray (DMX), or similar motion X-ray systems.DICOMetrics™ is designed to analyze original diagnostic DICOM radiographs acquired in defined static positions, such as neutral, flexion, extension, and lateral bending. These files contain the original image data and DICOM metadata—including pixel-spacing information—needed for accurate calibration and reproducible linear and angular measurements.Traditional fluoroscopy and DMX capture continuous motion as a sequence of frames. Exported video formats such as MP4, AVI, and MOV do not preserve the original DICOM image data and metadata required by DICOMetrics™ . Screenshots or still images extracted from these videos are also not accepted, as converting a video frame to an image does not recreate the original DICOM data or metadata.Some newer systems can acquire motion imaging in DICOM format. For example, Konica Minolta Healthcare's Dynamic Digital Radiography (DDR), also known as X-ray in Motion™, produces dynamic X-ray imaging as a sequence of digital radiographic images. If an individual image is extracted from a motion sequence as an original DICOM file that retains the required DICOM metadata, it can be uploaded to and analyzed by DICOMetrics. The selected images should represent the appropriate neutral and stress positions required for the analysis.In short: DICOMetrics™ does not accept motion video files, but it can analyze individual original DICOM images from compatible dynamic imaging systems when the required metadata is preserved.

DICOMetrics™ requires the original DICOM files exported from the imaging center’s X-ray acquisition system or PACS. These files contain the original image data and embedded metadata—including the calibration information needed for accurate measurements.Some online PACS portals allow physicians to download images labeled as DICOM but may create secondary or reformatted files that omit important original DICOM tags and metadata. These downloads may not be suitable for measurement.When referring a patient for imaging, ask the imaging center for instructions on the most efficient way to obtain the original, unmodified DICOM files with all metadata preserved. Depending on the facility, they may be provided through a full-study PACS export, secure download, CD, or another electronic delivery method.DICOMetrics™ accepts only original DICOM files with the required tags and metadata intact. Screenshots, JPEGs, PNGs, PDFs, reformatted DICOM files, and all other file formats are not accepted.

DICOMetrics™ calculates measurements using the spatial calibration data contained within the original DICOM images. This allows distances to be reported in physical units such as millimeters without relying on screen size, zoom level, or display scaling.As with any radiographic mensuration method, measurement quality also depends on proper image acquisition, positioning, image quality, and accurate anatomical landmark placement by the physician.

Yes. DICOMetrics™ supports biomechanical analysis using criteria and methodologies recognized in the AMA Guides to the Evaluation of Permanent Impairment, including the 5th and 6th Editions.The software provides quantitative analysis of intersegmental translation and angular motion to assist physicians in evaluating Alteration of Motion Segment Integrity (AOMSI) and other applicable biomechanical findings.DICOMetrics™ incorporates established references, including:AMA Guides to the Evaluation of Permanent Impairment, 5th and 6th EditionsWhite & Panjabi, Clinical Biomechanics of the SpineYochum & Rowe, Essentials of Skeletal RadiologyThe physician remains responsible for selecting the appropriate methodology and interpreting the findings within the context of the patient's overall impairment evaluation.

No. DICOMetrics™ does not generate or assign an impairment rating. An impairment rating is a clinical determination made by a qualified physician based on the patient’s complete clinical presentation and the applicable impairment-rating methodology.DICOMetrics™ is a physician-support tool that performs and documents objective biomechanical measurements from radiographic studies. When applicable, these measurements can help the physician identify the biomechanical component used in determining an overall impairment rating, including findings related to Alteration of Motion Segment Integrity (AOMSI).The physician remains solely responsible for reviewing the measurements, correlating them with the patient’s clinical findings, applying the appropriate criteria, and determining the final impairment rating.

DICOMetrics™ is designed to make CRMA analysis fast and efficient by combining image measurement, automated calculations, findings, and report generation into an intuitive workflow.Once the DICOM images are uploaded, the physician plots the required anatomical landmarks and DICOMetrics™ performs the applicable calculations, organizes the measurement results, and generates the CRMA documentation.Actual completion time varies based on the spinal region, image quality, study complexity, and user experience, but the workflow is designed to significantly reduce the time associated with manual measurement, calculation, and report preparation.

No specialized CRMA hardware or locally installed analysis software is required. DICOMetrics™ is browser-based and is designed to work with original DICOM radiographs exported from compatible digital X-ray or PACS systems.Users need a compatible web browser, internet connection, and access to the patient's original DICOM images.Because the analysis is performed within DICOMetrics™, there is no need to purchase or maintain a separate workstation dedicated specifically to CRMA analysis.

DICOMetrics™ provides comprehensive quantitative motion analysis of the cervical, thoracic, lumbar, and upper cervical spine—all within a single platform.For the cervical, thoracic, and lumbar spine, DICOMetrics™ analyzes neutral, flexion, and extension lateral radiographs to quantify intersegmental motion. The physician plots defined anatomical landmarks, and the software automatically calculates vertebral translation, angular motion, and applicable segment-to-segment comparisons across the evaluated spinal levels.Measurements are evaluated using the selected methodology and applicable reference criteria, allowing the physician to objectively document abnormal motion findings, including Alteration of Motion Segment Integrity (AOMSI) when the appropriate criteria are met.For the upper cervical spine, DICOMetrics™ analyzes neutral and right and left lateral-bending AP open-mouth radiographs to quantify C1–C2 motion and alignment, including atlas lateral displacement/overhang and peri-odontoid relationships.Each analysis brings the measurements, calculated findings, annotated radiographic images, methodology, and supporting documentation together into a clear, standardized CRMA report ready for physician review and finalization.

The report includes annotated radiographic images, intersegmental translation and angular measurements, calculated findings, applicable reference criteria, methodology, and supporting references.DICOMetrics™ generates a professional, structured CRMA (Computed Radiographic Mensuration Analysis) report designed to clearly document the quantitative analysis performed by the physician.The report organizes the relevant measurements and findings into clear documentation suitable for clinical and medico-legal use, while allowing the physician to review and finalize the analysis.

No. DICOMetrics™ is a physician-support tool and does not replace professional clinical judgment.The software provides tools for quantitative radiographic mensuration, performs calculations based on physician-selected anatomical landmarks, and organizes the resulting measurements and findings into standardized documentation.The physician remains responsible for reviewing the radiographs, verifying landmark placement and measurements, interpreting the findings, correlating those findings with the patient's clinical presentation, and determining their clinical significance.

DICOMetrics™ is designed to support HIPAA-compliant use and to protect the privacy and security of patient information.The platform incorporates multiple administrative and technical safeguards designed to protect electronic protected health information (ePHI), including:Encryption in transit and at rest to protect patient information during transmission and storage.Two-factor authentication (2FA) to provide an additional layer of security for user accounts.Role-based access controls to restrict access to patient information based on authorized user permissions.Automatic session timeout and logout to reduce the risk of unauthorized access from unattended devices.Audit logging to maintain records of system activity and access to protected information.Secure backups and disaster-recovery safeguards designed to protect against data loss and support system recovery.U.S.-based data storage for patient information and DICOM studies.Unique user accounts and authentication controls to help ensure that access to protected information is limited to authorized users.DICOMetrics™ also maintains a HIPAA compliance program and provides a Business Associate Agreement (BAA) to covered healthcare providers as applicable.HIPAA compliance is a shared responsibility. Healthcare providers remain responsible for using DICOMetrics™ in accordance with their own HIPAA policies, workforce access requirements, and privacy and security obligations.