A client of ours was stopped in afternoon traffic when a tractor came up behind her and never slowed down. She was belted in, the airbags never deployed, and the only part of her body that struck anything was her head against the driver’s side window. She went to the emergency room that same afternoon, had a CT of her neck and a CT of her brain, and both came back unremarkable. She was given a muscle relaxer and sent home with pain medication.
Three years later she had been through five rounds of trigger point injections, a cervical epidural steroid injection, a nerve study that lit up the muscles alongside her neck, two medial branch blocks, and a procedure that burned the nerves feeding her facet joints. It worked beautifully for about two months. Then the pain came back at 8 out of 10, and a surgeon raised the possibility of replacing a disc in her neck. Every one of those findings traced back to the afternoon the ER told her nothing was broken.
No. It means you don’t have a fracture and you don’t have bleeding on the brain.
That is a real and worthwhile thing to know. It is not the same as a clean bill of health, and the two get conflated constantly, by patients who feel relieved and by adjusters who find the distinction convenient.
The cervical MRI this client had four months later showed disc bulges at four consecutive levels, C3-4 through C6-7, along with a loss of the normal forward curve of the neck that radiologists associate with trauma. None of that appeared on the day-one CT. Nothing was hidden and nobody missed anything. The hospital ran the right test for the question in front of it.
They answer different questions, which is why the emergency room orders one and your treating doctor later orders the other.
A CT scan fires X-rays from many angles and reconstructs them into cross-sections. The National Library of Medicine describes it as showing the size and structure of organs, bones, and other tissues, and lists checking for internal bleeding or injury after trauma among its uses. It is fast, and it is very good at bone and at blood. An emergency physician needs to know within minutes whether you have a broken neck or a brain bleed. A CT answers that.
An MRI uses magnets and radio waves instead of radiation, and the same source describes it as showing organs and soft tissues clearly. Discs, ligaments, nerve roots, the spinal cord. It takes much longer, costs considerably more, and no emergency department is ordering one at four in the afternoon for a patient who walked in and can turn her head.
That is the whole gap. The scan that clears you for discharge is not the scan that finds a disc injury. An argument built on a clean day-one CT is really an argument that the triage tool should have found something it was never built to find.
Here’s the timeline from that file, because it is more useful than any general statement I could make about soft tissue:
Nothing about that arc is unusual. Neck injuries from a sudden force frequently start as stiffness and build. Radiating symptoms, the numbness and tingling that travel down an arm, often take weeks to appear and can take far longer to be pinned to a specific nerve root.
The bottom line: The question is never whether your injury showed up immediately. It’s whether the medical record connects what you have now to what happened to you then.
They write you a letter saying their review found no objective findings. A lot of people read that and stop.
It’s worth knowing the current climate. Auto insurers denied a striking share of claims last year, and a normal CT is the cheapest denial an adjuster will ever write. Three other things get used the same way:
In the case above, the client was in a second collision almost two years in. Her pain management physician compared the cervical MRI from months after the first crash against one taken after the second and found no meaningful change in the neck. That one comparison is what kept the cervical claim intact.
If a commercial vehicle was involved, the liability side of the case runs on a separate and much faster clock. That is its own subject, and we cover it in what Louisiana and Texas each make you prove after a truck rear-ends you.
This is where delay actually costs people their cases.
In Louisiana, for injuries sustained on or after July 1, 2024, La. Civ. Code art. 3493.1 gives you two years from the day the injury is sustained. Claims arising before that date fall under the old one-year period. In Texas, Tex. Civ. Prac. & Rem. Code § 16.003 has long set two years.
The medicine in the case above took three years to tell its story. The filing deadline did not extend to accommodate it. Start the legal work while the diagnosis is still developing, not after.
Longer than most people expect, and longer than most adjusters will concede. Stiffness and soreness often set in over the first 24 to 72 hours as inflammation builds. Radiating symptoms down an arm or leg can take weeks. In the case I described, the MRI that finally showed disc findings came four months out, and the nerve study confirming irritation came almost two years in. That delay doesn’t mean the collision didn’t cause it.
Probably, if the facts back it up. What matters is whether you reported pain at the scene or in the ER, whether you kept going back, and whether later imaging and nerve testing support a physical injury. A gap in treatment will hurt your claim far more than a normal first scan ever will.
Ask your doctor, not me, and ask if pain is persisting past a few weeks or anything is radiating into an arm or leg. I’m not in a position to order imaging or to tell you that you need it. What I can tell you is that an MRI is often the study that turns a disputed soft-tissue claim into a documented one.
Not by itself. It does mean your physicians have to separate the two injuries, and it means your lawyer needs that comparison in writing. In the case above, the doctor compared imaging from before and after the second collision and found the cervical findings unchanged. That’s what preserved the claim. Call me and I’ll tell you straight what I see in yours.
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701 Poydras St # 4100,
New Orleans, LA 70139
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