Preparing radiology images as court exhibits

Radiology evidence in a personal injury or workers' compensation case follows a predictable path: the patient gets an imaging CD, gives it to their attorney, and the attorney needs the images in a format the expert witness, court, and opposing counsel can actually view. The DICOM files on the CD are not that format.

A properly prepared radiology exhibit is a PDF (or a set of JPGs) showing the images with the correct clinical windowing — the same view the radiologist used when reporting the study. For a lumbar spine MRI, the soft tissue window that shows disc herniation and nerve root impingement; for an extremity X-ray, the bone window showing the fracture. The DICOM tags encode which window to use; a DICOM-aware converter applies them automatically.

Privacy matters at every step. DICOM files contain PHI — patient name, ID, date of birth, study date. Do not use an upload-based converter for imaging that will eventually enter a legal record: you have no control over how that third party stores or accesses the data. This converter processes files locally and transmits nothing.

DicomExhibit is not a medical device and does not provide clinical analysis. The conversion produces a faithful visual representation of the pixel data; clinical interpretation is the radiologist's job.

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The exhibit preparation workflow

  1. Copy the .dcm files for the relevant series from the imaging CD.
  2. Drop them into the converter and choose PDF output.
  3. Review the previews — check that contrast looks correct for the injury in question.
  4. Download the PDF. Label pages clearly (e.g., 'MRI Lumbar Spine, T2 Sagittal, [Date]').
  5. Retain the original .dcm files unchanged — the opposing expert may request them.

Questions

Do I need a radiology expert to prepare the exhibit images?

Not for the conversion — this is a format translation, not an interpretation. The radiologist's report documents what the images show; the exhibit images just need to be correctly rendered. That is a technical step, not a clinical one.

Should the exhibit show the same images as the radiology report?

Typically yes — the images the radiologist references in their report are the ones that support your case. Your attorney or expert will identify which series and which slices.

How do I handle multi-slice series?

Either include representative slices (a handful that clearly show the relevant finding) or the full series for completeness. For a court exhibit, the full version's batch PDF with one image per page keeps everything in one file.

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