1.1 Legal Ethics

WI state practice act regarding dry needling and blood flow restriction

not specified on whether we can or cannot perform

WI state practice act regarding PT use of roentgen rays/radium

PT can create an order for radiographs for diagnosis and POC, cannot physically administer the imaging

qualifications for ordering radiographs in WI

DPT from CAPTE accredited university, ABPTS speciality certification, ABPTRFE residency/fellowship training, or complete a formal a-ray ordering program

is it legal and ethical for all PTs to refer for medical imaging

no - only when clinically appropriate and with the appropriate training to refer

who interprets medical imaging

collaboration of health care providers including radiologist and referring clinician

how does the knowledge of imaging assist the practicing clinician

recognize, understand, communicate and integrate

recognize when

imaging is necessary for comprehensive evaluation or treatment planning (imaging is overutilizied)

understand enough

imaging to obtain information not stated in radiologist report (guide POC)

communicate effectively with

other health care providers (including appropriate terminology)

integrate information from

radiologists report into treatment plan and prognosis report

value of medical imaging decisions (radiographs or MRI)

structural images for anatomical accuracy, viewing above and below fracture for subsequent effects, statistical information to determine which modality is most appropriate for use, professional communication of imaging

understanding imaging parameters helps

reduce amount of radiographs ordered reducing cost, time and radiation exposure, and gives rapid results and fewer office visits

know the value of each diagnostic study

skill of operator, position, timing, interpretation linked to examination

timing of imaging is significant because

some injuries may present more/less depending on timing of imaging based on injury (stress fractures can take up to 6 weeks to show up)

imaging does not equal

examination, they are complimentary to eachother

imaging should be treated as a

special test - adds to diagnostic process but not the sole source of diagnosis

treatment planning with imaging

visualize exact location of fracture to plan intervention, determine is adjacent joint mobility is safe without compromising stability of fracture site, plan prognosis