Competency for Imaging Referral

Lynn McKinnis PT, DPT

Course Description

The purpose of this course is to enable physical therapists to achieve competency in referral for imaging. A vital function of practicing in a direct access capacity is the ability to refer correctly to other providers in a timely manner. For non-military physical therapists in the USA, referral to imaging may be a new experience. This course provides sufficient imaging modality description and application of current imaging guidelines to facilitate correct referral.

This course illustrates peer-reviewed musculoskeletal imaging cases from the archives of the Journal of Orthopedic and Sports Physical Therapy (JOSPT). These cases demonstrate excellent clinical decision skills and appropriate referral to imaging by physical therapists resulting in optimal patient care. The design of the course is interactive. The student is asked to make clinical decisions throughout each case.  A valuable feature of this course is the opportunity for the student to make a wrong clinical decision and see how it can lead to adverse consequences. The student is provided rationales to understand why a decision is wrong.  The course then returns the student to the critical decision point and allows them to choose a correct action. The cases then proceeds as in actuality, with optimal patient outcomes.

Prior to the cases, an overview of imaging modalities and evidence-based imaging guidelines are presented. The student is tasked with utilizing the American College of Radiology Appropriateness Criteria throughout the cases to emphasize correct choice of patient condition and variant when accessing this standard resource.

Solution Detail Image


  • Analyze clinical cases to recognize how information obtained from medical imaging advanced the physical therapy evaluation and treatment intervention of the patient
  • Distinguish, in a given clinical scenario, whether medical imaging is needed to advance the diagnostic investigation
  • Decide if it is safe to proceed with physical therapy intervention in the absence of medical imaging
  • Compare the capacities and limitations of radiographs, CT, MRI, US, and bone scan, to define pathology
  • Choose the correct evidence-based guideline to use in a given clinical scenario
  • Access the American College of Radiology Appropriateness Criteria© and deduce the correct clinical condition recommendation to use in a given clinical scenario
  • Justify use of Clinical Decision Rules (NEXUS, Canadian Cervical Spine Rule, Ottawa Knee Rules, Ottawa Ankle Rules)
  • Decide when and why the physical therapist communicated with the physician to optimize the management of patient care