Fast track referral pathway
February 27, 2018
Physiotherapy Matters can offer a fast track referral pathway for any of our patients requiring musculoskeletal imaging. This can include X rays or Magnetic Resonance Imagining (MRI).
So when would this be required?
Helen Curry talks to our Business Manager and Senior Physiotherapist Chris Barrett
MRI’s can be an invaluable tool in the diagnosis of some musculoskeletal injuries. Unlike x-rays, MRI’s can identify problems in both bone, ligaments and other connective tissue. They are used frequently by orthopaedic consultants if they suspect the person has a structural lesion which may be causing someone’s pain. In addition to consultants, our Senior Physiotherapists at Physiotherapy Matters can also refer for MRI scans.
Chris Barrett discusses one particular case who he saw recently which lead to a referral for an MRI
I saw Richard about one month ago when he came to see me after a skiing holiday. He had suffered an injury whilst skiing in France, unfortunately an out of control Brit collided with Richard sending him into a dramatic fall to the ground. Richard was aware of immediate pain in his knee and noticed a rapid increase in swelling. He went to visit the local hospital who x-rayed his knee and suggested that because his knee wasn’t broken, he would be better to seek treatment when he returned to the UK. Richard called Physiotherapy Matters as he left the hospital in France. He was back home within 2 days of suffering the injury.
I performed a thorough examination of Richard, this included an analysis of both bone, ligaments and muscle. He arrived walking with crutches and his knee was markedly swollen. We went through a series of tests including tests to assess the laxity of his ligaments. Ligaments attach muscle to bone and perform a vital role in stabilising joints throughout the whole body. Following the assessment, the findings were discussed with Richard. This included a long discussion about the “dreaded” ACL. Many people will of heard about the Anterior Cruciate Ligament, it’s a vital stabiliser in the knee. It restricts the forward movement of the shin bone relative to the thigh.
We discussed all treatment and assessment options and decided that he was happy to self-fund for an MRI scan which I could arrange within 2 days of the appointment. We provided Richard with a suitable appointment time for his scan and also provided him with some specific advice about immediate management. This included some advice about pain relief and some specific advice about starting to strengthen the structures around his knee. We also started some important hands on work to try to improve function within his knee.
Following his MRI, the results of the MRI were sent through to Physiotherapy Matters within 2 days of the MRI scan. I was able to ask Richard to attend our Gosforth clinic that day to discuss the findings of the scan. The results showed an acute tear of Richards Anterior Cruciate Ligament. We discussed the functional implications of this an1d concluded that he should seek an opinion from an Orthopaedic consultant with the potential for Richard to have it repaired. Although Richard was disappointed with the findings of the scan, he felt reassured that a suitable assessment had been conducted to establish what scan was required. Because of our fast track service we were able to provide Richard with answers with 4 days of his initial appointment at Physiotherapy Matters.
He went on to see a local Orthopaedic consultant who we recommended, he underwent a surgical repair within 2 weeks after the scan. He’s early days with his rehab but he’s showing good signs of getting back to normal and we may get him back on the slopes next winter!
MRI scanning is not the answer to all musculoskeletal injuries, the majority of injuries do not need an MRI to establish what is going on. Many injuries are “dynamic”, they are only caused by movement and do not include a tear, a strain or a bulge of a disc. In the case of Richard, I thought that a ruptured ACL was most likely and consequently I wanted this confirmed by the use of a MRI scan.
Physiotherapy Matters offer a complementary telephone triage service to discuss your injury and decide if you require a physiotherapy appointment.