When a patient's history and subjective complaints indicate possible musculoskeletal involvement of the torso, spinal x-rays are taken. This is legislated by each state in the scope of practice of Chiropractic; by the Chiropractic profession's clinical education and practice guidelines; as well as legal precedent. (Willet v Rowekamp, 1938)

The "Osseous Component" of the vertebral subluxation complex can only be objectively identified and documented, radiographically. It is incumbent upon the clinician to detect the osseous component of the vertebral subluxation complex for the following reasons:

Diagnose the presence, or absence of spinal improprieties.
Quantify the osseous component of the subluxation complex.
Correlate symptomatology with the evidence of trauma.
Design a treatment plan based on clinical protocol.
Provide a hard copy of the patient's biomechanical findings.

A follow-up comparative study is required after 8-10 weeks for the following reasons:

To re-evaluate patient's injury and progress (or lack thereof).
To score the level of impairment.
To determine the next phase of treatment (if required).
To discharge the patient and complete their outcome assessment.

However, there is a significant error rate for hand mensuration. [Up to 26%. Sigler & Howe, Inter & Intra examiner reliability of the upper cervical marketing system. JMPT 1985 8:75-80.]

Physicians are required by legal precedent to use the best factual data. In the Pennsylvania Supreme Court (Smith vs. Yohe, 1963) the court decided that the treating doctor was negligent for not using the best factual data upon which to arrive at his diagnosis.

Computer-aided Digital Radiographic Imaging provides the only precise objective analysis of the biomechanical improprieties of the spine in order to diagnose a subluxation, delineate an objective treatment plan and make comparisons at follow-up.