Academy of Orthopaedic Physical Therapy

American Physical Therapy Association (APTA)

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27.3 Clinical Imaging
Table of Contents

BASIC DIAGNOSTIC IMAGING PRINCIPLES

Abstract:

This monograph discusses basic diagnostic imaging principles that are essential for physical therapists to understand as they use the results of these imaging techniques in practice. Basic plain film radiography technology is discussed along with principles of viewing and interpretation. Advanced imaging techniques including computed tomography, magnetic resonance imaging, ultrasound, and common nuclear imaging studies are delineated. Basic principles of each technology are presented along with common clinical usage. Various typical clinical decision rules are described along with the decision making process that will be useful for physical therapists in different practice settings. Finally, the policy implications of physical therapists using various imaging technologies in practice for diagnostic purposes are discussed in conjunction with various American Physical Therapy Association House of Delegates positions, state practice acts, and state board policies and actions. Four case studies are included to demonstrate how diagnostic imaging is used in physical therapist practice. The first case describes a 51-year-old male who suffered an injury to his ankle while playing ice hockey. The second case involves a 48-year-old male who comes to physical therapy complaining of neck and arm pain. The third case is a 26-year-old female who suffered a lower leg injury while skiing. The fourth case is a 71-year-old male with an acute onset of back pain that is eventually diagnosed as infectious diskitis. Three of the four cases were through direct access visitation and involved treatment by a physical therapist who used imaging as a part of the diagnostic process and decision making for treatment.

Keywords:​

radiology, technology, plain film radiographY

References:

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IMAGING OF THE EXTREMITIES

Abstract:

This monograph discusses the role of medical imaging modalities in diagnosis and management of various musculoskeletal pathologies of the extremities. Topics covered in this course include evidence-based guidelines for the use of imaging modalities, examples of relevant imaging findings on medical images, and discussion of imaging findings in the context of clinical presentations of patients. Emphasis has been placed on pathologies of the pelvis and hip, knee, and shoulder, along with discussion of other common musculoskeletal conditions of the extremities. Three cases are presented. The first case is a 16-year-old male who presents with pain in the right hip and groin. The second case describes a 52-year-old male with a gradual onset of right knee pain over the previous 3 months without a history of trauma. The third case involves a 64-year-old woman with gradual onset of left shoulder pain over the past 10 months.

Keywords:​

radiograph, ultrasound, hip, pelvis, knee, shoulder

References:

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SPINAL IMAGING: UPDATE FOR THE TREATING PHYSICAL THERAPIST

Abstract:

This monograph provides physical therapists with an update in evidence-based imaging practices, including paradigm shifts in radiography, magnetic resonance imaging, computed tomography, bone scintigraphy, dual energy x-ray absorptiometry, and ultrasonography. The responsibility of physical therapists to consider imaging in clinical practice to enhance the care of patients with cervical, thoracic, lumbar, and sacroiliac conditions is discussed. Appropriate consideration and use of imaging requires knowledge of strengths and limitations of various imaging modalities, familiarity with imaging guidelines, and recognition of clinical presentations that warrant immediate referral and/or imaging, which are covered in this monograph. Two case studies are provided to demonstrate appropriate use of imaging in physical therapy practice. The first case is a 53-year-old retail sales manager with idiopathic-onset, right lower extremity pain aggravated with standing and improved with sitting. The second case is a 42-year-old secretary who presents to physical therapy 10 days following a motor vehicle collision with worsening neck pain and headaches.

Keywords:​

back pain, diagnostic imaging, neck pain, spine

References:

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Clinical Imaging

This series covers an introduction to the basic principles underlying the science and diagnostic utility of imaging for the physical therapist.

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