Week 1.2 The Role of PT in Imaging

Question 1

A patient can present to PT in one of two ways… what are they

Answer 1

with imaging already done, or with an injury and the suspicion that you need to order imaging.

Question 2

What does imaging allow for

Answer 2

more comprehensive evaluation, when you need it. It can give you an added dimension to anatomy.

Question 3

is imaging always a good idea

Answer 3

no, because if it does not change the treatment outcome, it will be not really benefit things

Question 4

what type of imaging should you get first

Answer 4

radiographs

Question 5

what is the PT role in imaging

Answer 5

• know scope of practice
• know when imaging is and is not needed
• integrate findings into POC
• know which modality to use for tissues
• communicate imaging info with the doc, radiologist and the patient.

Question 6

imaging is indicated when the information yielded would…

Answer 6

change the treatment plan

Question 7

what are some available clinical decision aids

Answer 7

• clinical decision rules, to determine risk levels
• ACR (American College of Radiology) Appropriateness Criteria (ID value of studies)
• Western Australia Diagnostic Imaging pathways (paths based on diagnosis)
• Discussion with doc or with a specialist.

Question 8

What are our 8 clinical decision rules

Answer 8

• acute cervical trauma
• acute ankle trauma
• acute knee trauma
• lumbar guidelines
• first time shoulder dislocation
• suspected compression fracture
• elbow extension sign
• acute radial wrist trauma

Question 9

what are the Ottawa Ankle Rules

Answer 9

• inability to near weight immediately after the injury OR
• point tenderness over the medial malleolus, or the posterior edge of the tip of the lateral malleolus or the tall or calcaneous OR
• inability to ambulate more than 4 steps in the ED

Question 10

According to the ACR of the Ottawa ankle rules, what is the recommended imaging

Answer 10

radiographs

Question 11

according to the rating scale, a number of 7,8,9 indicates

Answer 11

the imaging is appropriate

Question 12

what about a 1,2,3 and a 4,5,6

Answer 12

1,2,3 is not appropriate

4,5,6 is may be appropriate

Question 13

using the ACR guideline, what is recommended for a child over 5 with acute ankle injury and 1 week persistent pain if first radiographs are negative

Answer 13

MRI without contrast

Question 14

how do you use the ACR criteria if the first one is not a good image

Answer 14

you start with the most appropriate and you work your way down.