Ensure patient compliance with radiology

Patient compliance is one of the many challenges in a chiropractic practice.

While perusing the internet and discussing patient compliance with colleagues, I discovered a commonality among DCs; we all agreed that excellent communication is the key to the most successful outcomes. And, by clearly communicating with your patients about their diagnosis, treatment options and treatment plans, you can help them understand the importance of remaining in compliance.

It is important to keep your patients educated on the possible obstacles they may encounter during treatment, how to overcome them and how to avoid deteriorating health conditions. It is also important to provide a clearly outlined home care plan that will help your patients stay in compliance.

There are tools and technology available to help you overcome barriers to compliance, such as adopting a clear and effective communication strategy and using radiographs and advanced imaging, such as X-ray, MRIs, CT scans and computerized foot scans.

Radiology and advanced imaging

Radiology is an excellent resource for clarifying the relationship between the results of the X-ray, MRI and CT scans, and the symptoms or conditions being experienced, including patient history, clinical examination and orthopedic and neurological examination findings. Radiology images can detect postural alterations, vertebral body malpositions, bone density, osteoarthritis, congenital anomalies, prior trauma and pathology. Proper analysis often identifies the source of pain, reason for lack of motion, compensation, hypertonicity, decrease in recovery time and poor response to treatment.

Radiographs and advanced imaging tell your patients’ stories. Radiology imaging can spark communication about their history, concerns and ailments, possibly leading to referrals for further radiology imaging, laboratory testing or a specialist. DCs can use another imaging device, the computerized foot scanner, to scan for imbalances that contribute to problems in the foot/ankle, knees, hips and lower back. The foot scan can be compared to the X-ray findings of the extremities and spine for further biomechanical evaluation.

Case study

The following case study provides clinically relevant examples of imaging and how to correlate a patient’s symptomatology and examination findings. The examples illustrate how radiology can be a useful tool in ensuring patient compliance, enhancing the doctor/patient experience and improving patient outcomes.

The lateral view of the ankle consists of a bony spur or enthesophyte at the calcaneal attachment site of the Achilles tendon and plantar aponeurosis (fascia). The radiographs of the patient’s ankle would stimulate a conversation as to why they are experiencing pain and tenderness, hypertonicity, weakness, etc., and discuss the appropriate course of treatment.

Note: Normal osperoneum is adjacent to the navicular bone.

Correlating the computerized foot scan to the X-rays, the DC can emphasize the importance of a custom orthotic and/or other appropriate treatment to alleviate the abnormal stresses placed on the foot/ankle. This is an opportunity to educate the patient on how abnormal stresses of the foot/ankle can transfer to the remaining joints of the extremities and the spine.

The AP lumbopelvic X-ray of a patient experiencing chronic low-back pain consisting of a femoral head height, lower on the left of 6.7 mm relative to the right hip and hemipelvis.

Note: Right convexity of the lumbar spine, apexing at L3.

The computerized foot scan from the same patient with the AP lumbar spine X-ray demonstrates bilateral foot pronation. Showing the patient the results of the X-ray and foot scan and explain how they can be correlated to their musculoskeletal pain and biomechanical dysfunction of the pelvis, spine and extremities. Recommendations can be discussed, such as custom orthotics that support all three arches of the foot, heel lift and chiropractic treatment after determining the cause of the discrepancy of the femoral head height. With ongoing chiropractic treatment, this patient concluded with a six-mm heel lift on the left side and a custom orthotic, which resulted in decreased lower back pain. In addition, shared current research with the patient regarding the benefit of using custom orthotics and chiropractic care, which has been shown to reduce low-back pain by 34.5%.¹ Education gives evidence and validity of the patient’s diagnosis and treatment.

Final thoughts on imaging for best patient compliance

Utilizing radiographs and advanced imaging, such as MRIs, CT scans and computerized foot scans, along with reliable research, you can communicate your patients’ results, ensuring patient compliance, enhancing the doctor/patient experience and improving patient outcomes.

JENNIFER PEDLEY, MS, DC, CCSP, DACBR, a chiropractic radiologist, graduated from Northwestern Health Sciences University with her doctor of chiropractic degree. Several years after having a private practice, Pedley continued her education at the National University of Health Sciences to complete the radiology residency. She has a private radiology reading practice in Redlands, California, and enjoys reading X-rays and MRIs of the spine and extremities. She also lectures for various continuing education organizations, such as Foot Levelers and state associations. For more information, visit jprad.com.

 Reference

1. Cambron JA, et al. Shoe orthotics for the treatment of chronic low back pain: A randomized controlled trial. Arch Phys Med Rehabil. 2017;98(9):1752-1762. PubMed. https://pubmed.ncbi.nlm.nih.gov/28465224/. Accessed August 7, 2024.