Integrating Radiology and Physiotherapy in Patient-Centred Musculoskeletal Care: A Systematic Review

Abstract

Musculoskeletal disorders is a significant source of pain, disability, reduced physical functioning and health care utilization globally and targeted diagnosis and rehabilitative measures are needed. Radiology and physiotherapy are complementary parts of the musculoskeletal care, radiology gives the anatomical and pathological information while physiotherapy is a tool that converts the diagnosis into a personal functional assessment and rehabilitation plan. This systematic review focuses on the role of radiological assessment in patient-centred musculoskeletal care, and how this can integrate with physiotherapy, with an emphasis on diagnostic decision-making, communication between health professionals, treatment planning, outcomes and patient involvement. A literature search was undertaken to identify evidence for the clinical contribution of imaging modalities (radiography, magnetic resonance imaging, computed tomography and ultrasound) and physiotherapy assessment and rehabilitation interventions. The provided evidence suggests that integration of imaging with clinical and functional assessment can be useful to make appropriate diagnosis, treatment selection and monitoring of musculoskeletal conditions. Imaging results, however, can not always directly correlate with pain and/or functional impairment and thus a combination of imaging, patient history, physical exam and functional evaluation is required. Shared decision-making, patient-physician-communication, and radiologist-collaborative-communication could potentially further reduce unnecessary imaging, enhance clinical decision making, and enable personalised rehabilitation. They conclude that a combined, patient-centred approach, in which radiological information is connected to physiotherapy skills, can help to improve the continuity and quality of the musculoskeletal care. Research is needed to examine standardized interdisciplinary pathways, digital communication systems, and patient-reported outcomes to develop models of integrated practice.