X-ray, MRI and Ultrasound
Physiotherapists can order certain types of imaging when they feel it is important in the decision making process as to how best to proceed with treatment. Usually, the clinical examination will reveal most of the information needed to diagnose the problem and to guide treatment of the condition. However, in certain instances, further imaging may be necessary to ensure there are no contraindications to treatment, such as a fracture, or to reveal information that would change the course of treatment.
When is an X-ray, MRI, or ultrasound needed?
Although routine, an X-ray is often unnecessary unless there is concern about a fracture, a dislocation of a joint, advanced arthritic change, or other bony anomaly that requires medical attention. The exposure to radiation from X-rays should be minimized, and unless we are going to learn something we don't know from the examination or there is something in the history of the problem that raises concern, it is often not vital.
An MRI shows us more information regarding soft tissues than an X-ray will. It is useful in diagnosing ligament and tendon tears, nerve impingement, tumors, and other soft tissue irregularities. Just like with an X-ray, a good clinical examination will yield information about many of these issues, and unless there is great concern, an MRI is often not needed to manage most issues. An MRI is most valuable in determining serious pathology that concerns during the exam or history has brought to light, or for pre-surgical planning purposes.
An MSK Ultrasound, in many instances, will provide as much information as an MRI, although with lower resolution and at a lower cost and shorter wait time. This is useful in many of the peripheral joints.
Can all Physiotherapists order imaging?
Not all Physiotherapists can order these investigations. Only Physiotherapists who have taken extra university level courses and passed a certification examination are able to order imaging.
Do all of your Physiotherapists have these courses?
Currently, three of our Physiotherapists have completed their certification:
What if I am not seeing a different physiotherapist?
At South Edmonton Physical Therapy & Sport Rehab, we employ a team approach to treatment. If your therapist feels any additional imaging would be indicated in your situation, they will confer with one of our therapists who is certified to order imaging. This Physiotherapist will then examine you in relation to your treating therapist's concerns, and if they agree that it would be indicated, make the referral for you.
Is the imaging that a Physiotherapist can order covered by AHS?
X-rays and MSK ultrasounds referred by a Physiotherapist are covered by Alberta Health Services. At this time, an MRI ordered by a Physiotherapist is not covered and must be paid for privately. Depending on your health benefits, you may have access to additional coverage for an MRI.