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Basingstoke, RG21 4EB
Farnborough, GU14 7NA
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Diagnostic referrals are within the scope of practice of current Extended Scope Physiotherapists based upon the competencies used by the Chartered Society of Physiotherapy.

This scope refers to patients presenting with Musculoskeletal and Spinal conditions.  The patients could have one or more of the listed diagnoses as the reasons for their presentations.

List of Diagnostics an Extended Scope Physiotherapist can refer for are:

  • Ultrasound (US)
  • X-rays. 
    •   
  • Magnetic Resonance Imaging (MRI

 

 

 

  • Magnetic Resonance Imaging Arthrogram (MRI Arthrogram)

Face – orbital x-ray to exclude metal fragments in eyes prior to MRI.

UPPER LIMB
Children over the age of 16 years, and adults presenting with upper limb injuries; including:

  • Clavicular/ACJ/SCJ injuries
  • shoulder dislocations
  • rotator cuff injuries
  • Sub-acromial bursitis
  • supraspinatus tendinitis
  • ruptured biceps tendon
  • shoulder joint inflammation including capsulitis and impingement

X-rays for –

  • bony trauma
  • arthritis
  • calcific tendonopathy
  • gross rotator cuff tear
  • un-diagnosed shoulder pain over 5 months duration

U/S for- 

rotator cuff tear – not for surgery

MRI for–

  • Complex rotator cuff tears – surgical
  • Fractures
  • Malignancy

MRI + Contrast for–

Adhesive capsulitis – for hydrodilation or surgical release.

 MRI Arthrogram for

Instability/articular/labral tears.

  • Bursitis
  • Tendonitis
  • Arthritis
  • Fracture
  • Loose bodies

X-rays for-

  • Loose body
  • Osteoarthritis
  • Fracture

U/S for–

diagnostic injection for tendonopathy

MRI for–

  • nerve entrapment
  • tendonopathy – surgical
  • distal biceps tendonopathy

MRI Arthrogram for

  • loose bodies
  • articular cartilage damage
  • Tenosynovitis/carpal tunnel syndrome
  • Hand/Wrist fractures
  • Tendon and ligament injuries including UCL/Mallet injuries
  • Compartment syndrome
  • CRP
  • Rheumatoid/inflammatory arthropathy

X-ray for

  • bony injury
  • subluxation
  • arthritis

U/S for

  • Rheumatoid/Inflammatory arthropathy
  • Tendon rupture

MRI for–

  • tendon rupture
  • scaphoid fracture/osteonecrosis
  • volar plate and collateral ligaments

MRI + contrast for

  • ligament rupture
  • inflammatory arthropathy

MRI arthrogram for

  • TFCC tear
  • Interosseous ligaments and first row injuries
  • synovitis

LOWER LIMB
Children over the age of 16 years and adults presenting with lower limb injuries including:

  • Arthritis, Perthes
  • Bursitis
  • Tendonopathy/tears
  • pubic symphasis dysfunction/osteitis
  • post THR with new episode of pain

X-rays for

  • OA
  • Perthes
  • Post THR with hip pain

U/S for

  • gluts tendon tears
  • injection for bursitis if unguided ineffective
  • Osteitis pubis injection

MRI for

  • trochanteric/gluts bursitis – if surgical
  • Hamstrings tendonopathy – resistant to conservative treatment

MRI arthrogram for

  • labral tears
  • Meniscal injury
  • Cruciate ligament injury
  • Collateral ligament injury
  • Quadriceps & patellar tendon rupture/tendonopathy
  • Fat pad inflammation, Plica
  • Dislocation/maltracking patella
  • Patella fracture, Tibial plateau fracture
  • arthritis
  • Baker's cyst
  • SONK (Sudden Osteonecrosis of knee)
  • Chondromalacia patella
  • Osgood schlatters

X-ray for

  • OA
  • fractures
  • dislocation
  • SONK
  • patella alignment - (4 views weight bearing, long leg views for high tibial osteotomy)

U/S for–

  • Patella tendonopathy
  • pre patella bursitis
  • superior tib/fib joint injection

MRI for–

  • Meniscal tear,
  • degree of OA for ? TKR
  • unicondylar knee replacement or HTO.
  • Posterior lateral corner
  • Plica, fat pad
  • Ligament tear - ? surgical
  • tendonopathy’s/tears
  • Talar dome injury
  • Muscle tears
  • ligament injuries
  • DVT
  • Avulsion fractures
  • diastasis distal tib-fib joint
  • Arthritis, inflammatory arthropathy
  • Compartment syndrome
  • stress fracture

X-ray for-

  • fracture
  • OA
  • bony abnormality suspected

 U/S for–

  • tendon tears
  • tendonopathy
  • guided injections

MRI for

  • ruptures,
  • insertion of Achilles
  • talar dome
  • ligamentous disruption
  • stress fracture

MRI + Contrast for

  • inflammatory arthropathy
  • pressure testing for compartment syndrome
  • fractures and dislocations
  • stress fractures
  • plantar fasciitis
  • metatarsalgia
  • tendonopathy’s/tears
  • ligamentous injuries/ruptures
  • tarsal tunnel syndrome
  • fibromatosis
  • neuroma’s
  • plantar plate injuries
  • arthritis
  • inflammatory arthropathy

X-ray for

  • OA
  • Fracture
  • bony abnormality – weight bearing

U/S for-

  • plantar fasciitis – injection
  • morton’s neuroma diagnosis and injection if unguided failed
  • Tendon tears/tendonopathy
  • plantar plate injuries
  • fibromatosis
  • metatarsalgia injection

MRI for

  • fracture healing/stress fracture
  • tendon ruptures
  • morton’s neuroma pre surgery
  • plantar fasciitis pre surgery
  • tendon tears - ?for surgery
  • Osteochondral injuries
  • Plantar plate injury
  • tarsal tunnel syndrome
  • fibromatosis – if for surgery

MRI + Contrast for–

  • inflammatory arthropathy

SPINAL CONDITIONS
Children over the age of 16 years and adults presenting with neck, back, chest pain including:

  • suspected fractures of the cervical spine traumatic or osteoporotic
  • neural compression
  • disc prolapse
  • soft tissue lump
  • brachial plexus trauma
  • thoracic outlet syndrome

X-ray for–

  • suspected fracture
  • cervical rib

U/S for–

  • soft tissue lump

MRI for–

  • disc prolapse
  • neural compression
  • thoracic outlet
  • brachial plexus injury/lesion/neuritis
  • Costochondritis
  • fracture, serious pathology
  • scoliosis

X-ray for–

  • costochondritis
  • fracture
  • scoliosis – serious pathology
  • fracture
  • scoliosis
  • serious pathology
  • disc prolapse
  • neural compression
  • inflammatory arthropathy
  • DISH
  • Infection

X-ray for

  • fracture
  • scoliosis
  • inflammatory arthropathy – AS

MRI for–

  • disc prolapse
  • neural compression
  • sinister pathology

CTSCAN
 

  • If requested by radiologist review MRI to rule out sinister pathology
  • To see state of bone healing from fracture
  • For patients who can’t have an MRI ? CT arthrogram for labrum, meniscal tears