Week 1.3 PT Role in Imaging Part 2

Question 1

what must you consider when you are writing an order for an x-ray

Answer 1

• clinical hypothesis, am I the one who is supposed to be ordering?
• is it in my scope?
• will the result change my management?
• what is the cost and availability of the study? -what are the contraindications?
• what is the radiation exposure like?

Question 2

when writing an imaging order, what do you need to include

Answer 2

age, MOI, clinical signs and symptoms, results of other tests, modality requested, which side (R/L), my clinical hypothesis or suspicion, my contact info in case the results are urgent

Question 3

is it sufficient to use read the impression

Answer 3

no, you need to read the full results

Question 4

how do you share with the patients

Answer 4

call them with the results, or discuss in the clinic.
provide the results within the relevance of your physical exam
use patient centered language

Question 5

how do you document the imaging results

Answer 5

you document not only the results, but also the information you shared with the patient, and the questions you answered for the patient

Question 6

what if an image is STAT? give some examples?

Answer 6

activate the transport to the ER, 
vascular findings (DVT, Aneurisms, pseudo-aneurisms, dissections, fractures, critical region stress fractures)

Question 7

what does ASAP imaging mean? examples?

Answer 7

contact the PCP or specialist

neoplasms, complete contractile ruptures, posterolateral corner injuries, high ankle sprains, Lisfranc sprains

Question 8

what are routine images? example?

Answer 8

refer to the PCP and specialist,

other MSK diagnosis (not immediate)

Question 9

what does the article by Moore suggest about the ordering capabilities of PT vs orthopedics

Answer 9

PTs have a diagnostic accuracy of 74.5% and ortho has 80.8%, so there is very close agreement

Question 10

Crowell 2016 looked at the diagnostic accuracy of imaging in a direct access state. what were the notable findings

Answer 10

good accuracy of MRI findings, good surgical agreement, and comply with the ACR

Question 11

on average, how many visits before ordering MRI in DA

Answer 11

3

Question 12

% imaging orders that comply with ACR

Answer 12

83.2%

Question 13

what is the MRI/MRA diagnostic agreement %, and what about the board certified PT

Answer 13

64.8% and 3.03 x more likely to agree

Question 14

what about surgical agreement

Answer 14

90%