Module 1 Flashcards
Do at least most states practice acts include the duty to refer as a legal duty and responsibility of PTs?
Yes
What is required in order for PTs to be able to order imaging?
Post-professional training due to variability in entry level
What states allow the PT to order or perform imaging?
Colorado and Wisconsin (Wisconsin got it passed in their practice act)
Although PTs in some states may be able to order or perform imaging are they the ones reading it?
No radiologists will read the imaging
What do PTs need to know relative to imaging?
Know your scope of practice and when imaging is not needed
What do PTs need to integrate relative to imaging?
Findings into PT plan of care
What do PTs need to understand relative to imaging?
Image and report to gather PT relevant information
What do PTs need to communicate relative to imaging?
Imaging information with radiologist, physician, and patient
Imaging should be conducted for every patient who presents with MSK complaint? (True/False)
False
Imaging should only be considered when the provider expects the results to influence decision making and plan of care? (True/False)
True
Knowing when a patient should have imaging is a responsibility of a physical therapist? (True/False)
True
Knowing when the results of imaging would impact the PTs plan of care and PTs management of a patient is the responsibility of the PT? (True/False)
True
What are the clinical decision aids that are available to help determine if imaging is indicated?
Clinical decision rule
American college of radiology appropriateness criteria
Western Australia diagnostic imaging pathways
Discussion with primary physician or specialist
What are characteristics of the clinical decision rules?
Evidence based
Determine risk level to not miss serious conditions
What are the characteristics of the American college of radiology appropriateness criteria?
Evidence based
IDs high and low value studies based on clinical variants
What are the characteristics of the Western Australia diagnostic imaging pathways?
Pathways based on suspected diagnosis
What are the clinical decision rules of an acute ankle injury? (Ottawa rules)
Inability to bear weight immediately after injury
Point tenderness over medial malleolus, or the posterior edge or inferior tip of lateral malleolus or talus/calcaneus
Inability to ambulate for 4 steps in the ED
What is usually the initial imaging modality that is used?
Radiographs
What are the considerations for making a recommendation for imaging or directly ordering imaging?
Clinical hypothesis
Am I the one who should be ordering?
Will the results change my management?
Costs and availability
Contraindications and radiation
When would a discussion with a patients physician be appropriate prior to ordering or referring imaging?
If the results of imaging fall into the STAT or ASAP category
What is the STAT category in imaging?
Active transport to ER
Vascular findings like DVT, fractures, or critical region stress fractures
What is the ASAP category in imaging?
Contact physician immediately
Neoplasms, complete contractile ruptures, posterolateral corner injuries, high ankle sprains, and lisfranc sprains
What was the summary of both Moore and Crowell studies?
That PTs have a high percentage of correctness when they are the one who order imaging
Why is radiography the most common modality used in imaging?
First order diagnostic study
Little risk
Time effective
Cost effective
