topic Re: x ray or not?? in Wellness

x ray or not??

sarahpanda — Sat, 13 Jul 2019 10:12:18 GMT

An elderly friend of mine has been having some foot issues the last couple of months. She went to a podiatrist and he recommended she go to physical therapy. My question is: Wouldn't you think an xray should have been done prior to sending her to physical therapy for her foot?

Re: x ray or not??

gizmogal — Sat, 13 Jul 2019 10:42:27 GMT

I don’t agree. X-rays will only confirm or detect a defect in bone structures, not soft tissue. If the podiatrist has determined the problem is with muscles, ligaments or tendons, then physical therapy to correct or strengthen those tissues will be beneficial. If there is no reason to suspect bone damage because of the examination conducted, then there is no reason to pursue an X-ray.

Your friend can seek another professional opinion to assess her foot problem before starting physical therapy, but unless you are a foot specialist, I don’t think your opinion is valid. And any prior personal experience you might have with your own feet and foot specialists do not necessarily apply to your friend.

Re: x ray or not??

cherry — Sat, 13 Jul 2019 10:50:10 GMT

If she has something like plantars facsitis (sp)I don't know if it would even show up on an x ray..

Re: x ray or not??

Ruby Laine — Sat, 13 Jul 2019 12:19:02 GMT

Because of her age an x-ray would have been a good idea, however, a good PT or PTA should be able to tell if there’s a break anywhere. Stress fractures are hard to see sometimes even on an x-ray. A PT can recommend an x-ray, especially if your friend doesn’t improve with therapy. Feet are tricky things!

Re: x ray or not??

pupwhipped — Sat, 13 Jul 2019 12:31:21 GMT

Right or wrong, the podiatrists I've seen have always done an x-ray first thing. I suspect stress fractures, arthritis, bone spurs, etc. are common findings for them. Course no x-rays done for ingrown nails, flat feet, or corns. Haaaaaaaa!

Re: x ray or not??

colliemom4 — Sat, 13 Jul 2019 12:34:34 GMT

@cherry wrote:
If she has something like plantars facsitis (sp)I don't know if it would even show up on an x ray..

@cherry Years ago I was x-rayed for that lol.

Re: x ray or not??

gardenman — Sat, 13 Jul 2019 12:45:51 GMT

X-rays can be used to both determine the cause of a problem and to rule out a cause. Unless the symptoms and diagnosis was blindingly clear cut, I would think an X-ray would be advisable, but insurance companies tend to determine everything these days. Perhaps the doc needs pre-authorization for an X-ray but not for PT and doesn't want the hassle of dealing with an insurer. Maybe it was an obvious diagnosis. Maybe the doc gets kicked back money from the PT but not the X-ray facility. You never know what the determining factor is these days.

Re: x ray or not??

Bri369 — Sat, 13 Jul 2019 13:45:37 GMT

I think an Xray should have been ordered to rule out a possible break or something else going on with her foot. Xrays can pick up more than just bone issues. There could be a spur even.

Re: x ray or not??

sfnative — Sat, 13 Jul 2019 21:06:15 GMT

@sarahpanda

Due to the age of your friend, I'd want to want to rule out a compression fracture and you can't do that by palpation. The foot is a funny appendage: so much to rule out.

Re: x ray or not??

chrystaltree — Sat, 13 Jul 2019 21:27:14 GMT

No. Xrays are used for bone issues, it she was complaining about soft tissue pain. An xray wouldn't be ordered. Since the podiatrist ordered PT, I assume it was some type of soft tissue sprain or strain or pain. When I had my neck pain, my orthop did not order an xray because he could tell from my description of the pain and from his examination that I didn't have a disc problem. They learn that stuff in medical schools, in this case podiatry school. So, have so faith in the professionals.

Re: x ray or not??

chrystaltree — Sat, 13 Jul 2019 21:26:32 GMT

@pupwhipped wrote:
Right or wrong, the podiatrists I've seen have always done an x-ray first thing. I suspect stress fractures, arthritis, bone spurs, etc. are common findings for them. Course no x-rays done for ingrown nails, flat feet, or corns. Haaaaaaaa!

First, they wanted the reimbursement for the xray so the routinely order one for everyone who walks in the door. But if they are truly doing their job correctly, they can tell from the physical exam and the patients description of the pain. How the pain feels, where it the pain is, when the pain started, did the patient have a recent foot injury, did the patient have an old foot injury. And then there's the patient's history and age.

Re: x ray or not??

GiantsLover — Sun, 14 Jul 2019 04:37:22 GMT

I would definitely have an xray done first to rule out other causes, and then pursue proper foot treatment after reading the xray expert results and advisements.

Re: x ray or not??

Mindy D — Mon, 15 Jul 2019 18:15:38 GMT

@sarahpanda wrote:
An elderly friend of mine has been having some foot issues the last couple of months. She went to a podiatrist and he recommended she go to physical therapy. My question is: Wouldn't you think an xray should have been done prior to sending her to physical therapy for her foot?

Whether she needed an X-ray or not depended upon the doctors examination of her feet and her discussion of her sympoms. There are many conditions that are diagnosable without Xrays.