title: Clinical diagnostic accuracy and magnetic resonance imaging of patients referred by physical therapists, orthopaedic surgeons, and nonorthopaedic providers.
abstract: METHODS
  Nonexperimental, retrospective design.
  
  
  OBJECTIVE
  This study was designed to compare clinical diagnostic accuracy (CDA) between physical therapists (PTs), orthopaedic surgeons (OSs), and nonorthopaedic providers (NOPs) at Keller Army Community Hospital on patients with musculoskeletal injuries (MSI) referred for magnetic resonance imaging (MRI).
  
  
  BACKGROUND
  US Army PTs are frequently the first credentialed providers privileged to examine and diagnose patients with musculoskeletal injuries. Physical therapists assigned at Keller Army Community Hospital have also been credentialed with privileges to order MRI studies for several years.
  
  
  METHODS
  To reduce provider bias, a retrospective analysis was performed on 560 patients referred for MRI over an 18-month period. An electronic review of each patient's radiological profile was performed to assess agreement between clinical diagnosis and MRI findings. Data analyses were performed through descriptive statistics and contingency tables.
  
  
  RESULTS
  Analysis on agreement between clinical diagnosis and MRI findings produced a CDA of 74.5% (108/145) for PTs, 80.8% (139/172) for OSs, and 35.4% (86/243) for NOPs. There was a significant difference in CDA between PTs and NOPs (P<.001), and between OSs and NOPs (P<.001). There was no difference in CDA between PTs and OSs (P>.05).
  
  
  CONCLUSIONS
  Clinical diagnostic accuracy by PTs and OSs on patients with musculoskeletal injuries was significantly greater than for NOPs, with no difference noted between PTs and OSs.
authors.affiliation: Sports Medicine Services, 67th Combat Support Hospital, Tikrit, Iraq. josef.moore@us.army.mil
authors.forename: Josef H
authors.initials: JH
authors.lastname: Moore
authors.forename: Donald L
authors.initials: DL
authors.lastname: Goss
authors.forename: Richard E
authors.initials: RE
authors.lastname: Baxter
authors.forename: Thomas M
authors.initials: TM
authors.lastname: DeBerardino
authors.forename: Liem T
authors.initials: LT
authors.lastname: Mansfield
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Fellows
authors.forename: Dean C
authors.initials: DC
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001842:Bone and Bones / Q000293:injuries* / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries* / Q000473:pathology*; D015588:Observer Variation; D009985:Orthopedics / Q000592:standards; D026761:Physical Therapy Specialty / Q000592:standards; D011320:Primary Health Care; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012189:Retrospective Studies