Episode
Ep46: When Physios Can Order Imaging: Smarter Imaging, Better Care with Jack Miller and Rob Werstine
- Podcast
- Paincast
- Published
- Mar 18, 2026
- Duration seconds
- 4092
- Processing state
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Summary
In this episode, we discussed: The principal use of diagnostic imaging and laboratory testing: When it should be used and when it shouldn't be used The limitations of diagnostics and ramifications of overuse on psychological, behavioural, and systemic levels Improving providers' literacy and patient education around diagnostics The impact of physiotherapists having the scope expansion and the current state of advocacy on this topic Resources The Canadian C-spine Rule The Ottawa Ankle Rule The Ottawa Knee Rule Canadian Association of Radiologists Utilization Guideline American College of Radiologist Appropriateness Criteria Brinjikji, W., et al. (2015). MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. American Journal of Neuroradiology, 36(12), 2394-2399. Flynn, T. W., et al. (2011). Appropriate use of diagnostic imaging in low back pain: a reminder that unnecessary imaging may do as much harm as good. journal of orthopaedic & sports physical therapy, 41(11), 838-846. Sajid, I. M., Parkunan, A., & Frost, K. (2021). Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care. BMJ open quality, 10(3). Scott, I. A., Slavotinek, J., & Glasziou, P. P. (2024). First do no harm in responding to incidental imaging findings. Medical Journal of Australia, 220(1), 7-9. Sharma, S., et al. (2021). “I would not go to him”: Focus groups exploring community responses to a public health campaign aimed at reducing unnecessary diagnostic imaging of low back pain. Health Expectations, 24(2), 648-658. VOMIT (Victim Of Medical Imaging Technology) Poster: https://www.aptei.ca/product/vomit-radiology-fa…