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  • Nicolas Pahud

The Role of Diagnostic Imaging in Physiotherapy Practice

Updated: Jan 11, 2023

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Effective October 6th, 2022, diagnostic imaging services referred by authorised physiotherapists are now insured under the Alberta Health Care Insurance Plan (AHCIP). Imaging is a useful resource for musculoskeletal conditions and can be a valuable tool for physiotherapists when used appropriately. Diagnostic imaging in the form of X-ray, Ultrasound and MRI are common in the private clinic setting. It generally is requested to rule in or rule out certain conditions and to help make a diagnosis. Patient’s frequently have imaging done prior to seeing a physiotherapist believing it is necessary to receive the appropriate treatment. Surprisingly, for many, this is not the case.

Orthopedic physiotherapists are trained to evaluate and treat people without the use of

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diagnostic test results. The imaging findings are always appreciated, but physiotherapists do not evaluate, prescribe exercise, or otherwise create treatments based on imaging findings. Image findings play only a small role in a patients treatment. Just as a picture of someone will only tell very little about their personality, a still image of a body part will only tell a physiotherapist a little about the injuries behaviour. It simply cannot describe how someone is feeling, what movement restrictions they are experiencing or how their body responds to pain. Pain and injuries are complex and experienced differently by everyone.

A physiotherapist will rely primarily on the patient’s detailed history and physical assessment to determine the most appropriate treatment for that individual. Each patient, even ones with the same image findings or diagnosis, will have a different presentation and experience dissimilar symptoms. Medical imaging can provide valuable information to the right people. However, it rarely influences the decisions an orthopaedic physiotherapist makes regarding someone’s care.

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It is important to know when imaging is appropriate, as unnecessary imaging will waste financial resources, increase possible wait times and could bring about findings that are “incidental” - slight abnormalities or natural changes that are not limiting the person’s functionality in any way. Research has repeatedly exhibited all kinds of “incidental findings” in asymptomatic people but that once determined could cause more stress or anxiety than is warranted.

Come see our authorised orthopedic physiotherapist at SHIFT and they will be pleased to perform an in depth musculoskeletal evaluation and then discuss with you your medical imaging findings or whether diagnostic imaging is the appropriate next step. If it is, we will be happy to make that referral for you!


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