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Normal age-related changes need to be discussed & put in context - but sometimes the pendulum swings too far.
The incidence of these changes is in the asymptomatic population and many morphological changes are present as people age. 1/ https://twitter.com/PhysioMeScience/status/1349050919116271617
The incidence of these changes is in the asymptomatic population and many morphological changes are present as people age. 1/ https://twitter.com/PhysioMeScience/status/1349050919116271617
This demonisation of imaging is primarily driven by those who rarely use imaging practice or have experience where imaging findings are poorly correlated to clinical symptoms. This may lead to poor outcomes, or may not, we don't know. 2/
What we do know is that there is a cohort of patients who cling to these diagnosis as their labels and it can become part of their persona. This can be difficult to adjust and these patients may seek unjustified interventional treatment. There are also those who don't. 3/
I regularly see patients referred for unnecessary imaging & treatments daily. I also see those where is entirely appropriate, and others where, primarily allied health practitioners, have advised against and deterred imaging or interventional procedures when it is justified. 4/
Now don't get me wrong, I feel that conservative management and load/exercise-based medicine is the mainstay of most musculoskeletal medicine, but there is a time and a place for imaging and interventional medicine. 5/
The reason that I am cranky today results from a patient that I saw as a follow up today. Referred 2/12 ago for ultrasound imaging for her medial ankle pain +/- injection. Dx: Tib post tendinopathy. 6/
We discussed findings and treatments and she elected to see a Physio for a load-based exercise program and assess the biomechanical changes to her foot/ankle. 7/
She now returns (in sandals) 2/12 later via her GP with increasing pain, decreased mobility and unable to single leg calf raise - this time for injection therapy as she had 'failed physio'. 8/
We discussed how the Physio went over her 8 sessions. Her 'Physio' advised:
-Over 50% of the population has a Tendinopathy - this is normal for age and doesn't matter or need treatment
-Exercise-do whatever makes you happy
-Do neural glides
-Cancel your podiatrist appointment 9/
-Over 50% of the population has a Tendinopathy - this is normal for age and doesn't matter or need treatment
-Exercise-do whatever makes you happy
-Do neural glides
-Cancel your podiatrist appointment 9/
Now this is just shit treatment and now we are injecting a tib post. I'm worried that this demonisation of radiological findings is having a negative impact in certain situations - I'm seeing it more and more from the younger allied health field. 10/
Don’t throw the baby out with the bath water.
Imaging has a role to play - put it in context.
If they fit clinically and radiologically - then that's their issue
For the love of god - load a Tendinopathy!
Rant over!
Imaging has a role to play - put it in context.
If they fit clinically and radiologically - then that's their issue
For the love of god - load a Tendinopathy!
Rant over!
