Correlation Between Magnetic Resonance Imaging Findings and Advanced Practice Physiotherapists' Assessment Findings in Diagnosing Lumbosacral Radiculopathy, and the Impact of Imaging Findings on Treatment Plans: A Retrospective Clinical Audit.

Publisher: John Wiley & Sons Ltd Country of Publication: England NLM ID: 101181344 Publication Model: Print Cited Medium: Internet ISSN: 1557-0681 (Electronic) Linking ISSN: 14782189 NLM ISO Abbreviation: Musculoskeletal Care Subsets: MEDLINE

Publication: [Hoboken] : John Wiley & Sons Ltd.
Original Publication: London : Whurr Publishers, 2003-

Radiculopathy*/diagnosis ; Radiculopathy*/diagnostic imaging ; Magnetic Resonance Imaging*; Humans ; Retrospective Studies ; Male ; Female ; Cross-Sectional Studies ; Middle Aged ; Adult ; Clinical Audit ; Lumbosacral Region/diagnostic imaging ; Physical Therapists/statistics & numerical data ; Aged

Background: Magnetic Resonance Imaging (MRI) is increasingly used by Advanced Practice Physiotherapists (APPs) to confirm the diagnosis of lumbosacral radiculopathy (LSR) and to exclude other spinal pathologies. There is evidence of correlation between Advanced Practice Physiotherapists' diagnosis of lumbosacral radiculopathy and positive MRI findings, but there is limited evidence regarding the correlation between the full physiotherapy assessment and MRI findings. There are also conflicting evidence regarding the effect of MRI findings on treatment planning post-imaging.
Aims: This study aims to examine the extent to which Advanced Practice Physiotherapists' diagnoses of lumbosacral radiculopathy correlate with those made after MRI, and to examine Advanced Practice Physiotherapists use of the local MRI referral pathway with respect to treatment plans, including testing correlation between pre-and post-MRI treatment plans.
Methods: A cross-sectional, multi-centre, retrospective audit was conducted on 482 patients (276 female, 206 male) referred for lumbosacral MRI between January 2018 and December 2019. Non-linear regression analysis was performed to examine the relationships between diagnosis and treatment plans in LSR before and after MRI.
Results: The results show a significant positive correlation (p < 0.001; R = 0.196) between pre- and post-MRI diagnoses of lumbosacral radiculopathy. There was a significant positive correlation between pre- and post-MRI treatment plans for LSR (p = 0.001; R = 0.159). On comparison of pre- and post-MRI diagnoses of LSR, there is a weak positive correlation with high statistical significance (p < 0.001; R = 0.196). Reliability, tested using the intraclass correlation coefficient (ICC) across the four categories, was (p = 0.041; R = 0.033). This shows a weak positive correlation with statistical significance.
Conclusions: Advanced Practice Physiotherapists can confidently diagnose and treat lumbosacral radiculopathy following initial assessment, although a minority of referrals lack a clear or appropriate treatment plan.
(© 2024 John Wiley & Sons Ltd.)

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Keywords: advanced practice physiotherapist; diagnoses; lumbosacral radiculopathy; magnetic resonance imaging; referral pathway; treatment plans

Date Created: 20241006 Date Completed: 20241006 Latest Revision: 20241018

20241019

10.1002/msc.1944

39370548