In 2013, Alberta Health granted physiotherapists ordering privileges for certain types of diagnostic imaging (ray, ultrasounds and MRI). This was another step in the advancement of primary care practice for physiotherapy in Alberta.
Physical therapists are considered primary care providers for bone, muscle and joint problems. If your physio is qualified to do so, they can also order diagnostic ultrasound as well as magnetic resonance imaging.
In tricky cases, I certainly utilize whatever tests may be needed to get to the bottom of things for you. One of the rights that separates chirps and MD's from physical therapists is the ability to order imaging.
A significant component of our doctoral education is built upon understanding imaging, so the APA and subsidies in each state have been working on getting physical therapists the right to order x-rays. While this is a significant step forward in public perception and autonomy as a profession, I have some very strong concerns. If you pay attention too much of the pain science research, you likely are aware of the large number of studies that reveal the lack of correlation between imaging findings and pain.
Remember, the imaging should not guide our treatment, unless managing the condition is outside our scope of practice i.e. a fracture, infection, etc. Show the rest of the country that we won't abuse the power of ordering x -rays and potentially harming our patients! If you are looking to improve upon your clinical skills and orthopedic knowledge, consider joining OPTIC's COME program.
Chris Duffy graduated from University of Queensland in 1983, and after working in a hospital and private practice, established the Forming Physiotherapy and... Imaging is a useful resource for musculoskeletal conditions and is an invaluable tool for physical therapists when used appropriately.
Magnetic Resonance Imaging (MRI) is a map of hydrogen atoms within the body. Hydrogen atoms are ideal for MRI because they possess a single proton and a large magnetic moment.
There are multiple types of MRI based on if the image is captured at a different decay of signal. A T2 weighted MRI captures the late stage of signal decay, or after a small amount of proton migration from the original resonance.
A gradient echo adds sensitivity or iron-complexes such as articular cartilage defects and hemorrhaging in muscle, but conversely decreases resolution on metal hardware (such as pins or screws) from a surgery. Spin echo adds the benefit of increased tissue contrast and better visualization of meniscal tears.
Pacemakers, aneurysm clips, cochlear implants, and orbital foreign bodies Projectiles in the room (includes oxygen tanks, IV poles, stethoscopes, hair pins, etc In the medical field, radiography is used to diagnose or treat patients through the recording of images of the internal structure of the body.
CT's scans are primarily used for bony pathologies, but can also be used for soft tissue dysfunction. Other benefits of CT scans are that they are fast, relatively inexpensive and often a good alternative to MRIs if an MRI is contraindicated.
Traumatic injuries Degenerative conditions, such as stenosis and osteoarthritis when an MRI is contraindicated Post-operative conditions Neoplastic conditions Infectious processes Image guidance during injections, biopsy’s and aspirations Abnormalities of bony alignment, such as scoliosis Processes involving the spinal cord when MRI is contraindicated As the body begins its metabolic activity at the site of the injury, the blood tagged by the radioactive compound is absorbed in the bone and the gamma radiation at the site of the injury can be detected with an external gamma camera.
Van Mulder MW, Tutu M, Pen nick V, Bombardier C, Assendelft WSJ. Quality of primary care guidelines for acute low back pain.
Freeborn DK, She D, Muttony JP, Eraser S, Romeo J. 5.0 5.1 5.2 5.3 McMahon KL, Coin G, Galloway G. Magnetic resonance imaging: the underlying principles.
Diagnostic Imaging in Physical Therapy Avoiding the Pitfalls. 7.0 7.1 Swain J, Bush K. Diagnostic Imaging for Physical Therapists.
Each one, regulated by the College of Physiotherapists of Ontario, is an important, though often overlooked, contributor to the wellness of our provincial health care system and the quality of life of many Ontarian's. Over time, and through amendments to the Physiotherapy Act, the government of Ontario has increased the number and kinds of services that the province’s physiotherapists are authorized to perform.
Most recently, the Ministry of Health and Long-Term Care announced the government’s intention to expand the scope of practice to allow physiotherapists to order X-rays, laboratory tests and diagnostic ultrasounds. In reality, however, it is an important signal from the government that the nature of primary health care is changing in significant ways.
As Ontario continues to implement its Patients First strategies and increases access to a range of health care services, delivered by highly trained, highly regulated allied health care professionals such as nurses, nurse practitioners, pharmacists and physiotherapists, it is important that we understand this changing landscape. According to the College of Physiotherapists of Ontario, physiotherapy is “treatment to restore, maintain, and make the most of a patient’s mobility, function, and well-being.
We fully realize the value of these professionals when we look at how they can alleviate not only our pain but the chronic pressure on our current health care system. Once patients find a physiotherapist through their own research, word of mouth or using an online search tool like the pt Health clinic locator, they can book themselves an appointment, as they do when they see a physician.
Allowing them to order diagnostics will significantly reduce wait times in family doctors’ offices, walk-in clinics and emergency rooms. If the government of Ontario is in fact committed to ensuring access, then it needs to continue to empower physiotherapists and other allied health professionals.
Otherwise, Ontarian's will continue to struggle to overcome unnecessary, wholly removable barriers in order to access the treatment they need.