A Case Study: Why is it important to correlate your scans to your specific injury

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As Physiotherapists, we are trained to assess and diagnose a large number of musculoskeletal injuries. A lot of times we are able to save patients the time and cost associated with getting a scan by diagnosing the injury and mapping out a treatment plan to achieve your recovery goals. When we are unsure or if there is concern for a major injury, we will then recommend a scan and/or referral to a specialist.

One other reason to avoid scanning is to avoid unnecessary fear by having a scan show up something “abnormal”, which in fact has nothing to do with the presenting symptoms. As an example, more research is coming to the surface about the presence of meniscus tears on an MRI scan in people who do not exhibit any knee pain.1

I recently had a client who started to develop knee pain whilst doing her home exercises. She did not twist or injure her knee in any way to cause this discomfort. She tried resting from the painful exercises for a couple of weeks however when she tried them again the pain came back. The pain was worst when climbing stairs at work. This client went to her GP and was immediately referred for an MRI, which had showed a meniscus tear among other findings. The GP then referred her to an orthopaedic surgeon, who after reading the scan and doing an assessment of this client, determined that the pain did not come from the meniscus tear and did not require surgery. The surgeon recommended physiotherapy as he believed the issue was a strain of the kneecap joint which could be treated with manual therapy and a strengthening program.

By the time this patient came to physiotherapy, she had been dealing with this injury for over six months. In less than three months, this patient underwent a course of physiotherapy and rehabilitation to get her knee feeling pain free and strengthened to return doing her exercise program without any restrictions. As a result of treatment, this patient was able to climb stairs and do her regular exercise routine with no pain or limitations.

If this patient had of come to physiotherapy first, she would have been able to avoid the cost and time associated with a GP consult, MRI scan and a specialist appointment, as well as returning to exercise a lot sooner.

So if you are unsure about a particular injury that you have sustained, come for a musculoskeletal assessment from your physiotherapist who will be able to determine whether physiotherapy treatment or a referral for scanning is appropriate. Even if the physiotherapist recommends a referral, they may be able to start your treatment straight away whilst you are waiting for your appointment.

References:

1Incidental Meniscal Findings on Knee MRI in Middle-Aged and Elderly Persons https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897006/

Blog Article written by: Physiotherapist Nick Wrenn

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