EXTENDED SCOPE PHYSIOTHERAPISTS: HOW OFTEN DOES THEIR CLINICAL DIAGNOSIS AGREE WITH THE MRI SCAN?

Abstract

Objective: To determine whether extended scope physiotherapists (ESP’s) in spinal clinics are able to accurately assess and diagnose patient pathology as verified by MRI findings.

Methods: This is a prospective study of 318 new spinal outpatients assessed and examined by one of two spinal ESP’s. 76 patients (24%) were referred for an MRI scan. At the time of request for MRI scan the likelihood of specific spinal pathology correlating with the MRI scan was noted on a four point scale dividing the patients into 4 groups:

• Group 4 = Very high suspicion of pathology (n=41)

• Group 3 = Moderate suspicion of pathology (n=21)

• Group 2 = Some suspicion of pathology (n=10)

• Group 1 = Pathology unlikely but scan indicated eg thoracic pain (n=4).

Results: Of the 76 patients referred for an MRI scan, 54 (71%) had an MRI scan result that would correlate with the clinical picture. Looking at the percentage of scans correlating with the clinical picture for each of the 4 groups:

• Group 4: 88%

• Group 3: 67%

• Group 2: 40%

• Group 1: 0%

Conclusion: Dividing the patients into groups by clinical suspicion is essential for evaluating a clinician’s ability in spinal assessment. Further evaluation of Consultants, Fellows and Specialist Registrars is on going. This type of study could form a basis for competency measures for staff development and training if they are undertaking extended roles.