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Referral for Imaging is a clinical decision that can be worked through with a shared decision making framework in mind.

A Cogent Argument
1. What is suspected and if this is found how it will alter management of my condition
2. Patient Consent

General Reasons for Imaging in MSK Conditions

Suspected Pathology
Trauma Significant Enough to Likely Cause a Fracture
Chronic Steroid Use
Particular Symptoms with Neck Movement e.g. ligament laxity
Sustained and unexplained raised temperature above 38 degrees celcius
Sustained and unresponsive hyperreflexia
Suspected spinal anomalies
Suspected active inflammatory arthropathy
Scoliosis progression associated with onset of pain change

Specific MSK Reasons

Symptoms remain unresponsive to Chiropractic Care after 4 weeks (Royal College of Chiropractors) and 6 weeks (IRMER Regulations) of Chiropractic Care Management
Inconsistent (strange) and or persistent paradoxical bio-mechanical findings
Limited evaluation due to pain, where person does not prefer a trial of treatment

Reasons that do not constitute reason to refer for imaging

Acute Low Back Pain with or without neurological signs
To analyse biomechanical changes / alignment (eg Gonstead or Biophysics technique systems)
Screening for pathology or sometimes called a contraindication screen
Recent films have already been taken

NB. Human adult females of childbearing age that have any chance of being pregnant should not be imaged using ionising radiation techniques.

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