Imaging and investigations
As a specialist Sport and Exercise Medicine service, we can request imaging and investigations that GPs are not always able to access under Medicare.
Imaging is most useful when it answers a specific clinical question. Specialist sport and exercise medicine uses imaging deliberately: the right modality, at the right time, to clarify a diagnosis or change a plan. As a specialist service, we can request imaging that GPs are not always able to access under Medicare.
Bulk-billed MRI
Specialist Sport and Exercise Medicine Physicians can refer for an MRI under Medicare item numbers that are bulk-billed at some participating radiology providers, which usually means no out-of-pocket cost for the scan (bulk-billing is at the radiology provider's discretion). GPs cannot refer for a Medicare-rebateable MRI for many musculoskeletal conditions; the specialist referral changes that.
MRI is used for soft tissue injuries: ligaments, menisci, tendons, muscle injuries, and bone marrow oedema.
Ultrasound
Diagnostic ultrasound is excellent for tendons, bursae, superficial muscle injuries, and some joint and ligament problems. Ultrasound is dynamic, meaning it can show how a structure behaves with movement, which static imaging cannot. It is also widely available and lower cost than MRI.
Ultrasound is also used to guide some injection procedures, improving accuracy and safety. See injection therapies.
Other imaging
- X-ray: first-line for bony injury, joint alignment, and screening for arthritic changes
- CT: superior bony detail, used for complex fractures and selected spinal investigations
- Bone scan and SPECT-CT: useful for localising pain, including in multi-level degenerative disease of the spine
- EOS imaging: low-dose, weight-bearing whole-body imaging for alignment and scoliosis
- DEXA: bone density assessment
- Pathology: blood tests, joint fluid analysis, and other investigations as indicated
When imaging is and is not useful
Imaging is useful when the result will change management. It is less useful (and sometimes counter-productive) when:
- The diagnosis is already clear clinically and the management does not depend on imaging
- Findings are likely to be incidental and unlikely to be the source of pain
- The patient's wider context (age, prior imaging) means new findings will not change the plan
The specialist consultation discusses whether imaging will move the plan forward.
Common questions
Will I need an MRI?
This can be discussed at a specialist consultation, after the history and examination point to a specific question.
What does bulk-billed mean?
The radiology provider accepts the Medicare rebate as full payment, with no out-of-pocket cost. Most participating providers bulk-bill specialist-referred MRI for relevant indications, at the provider's discretion.
How quickly can I get a scan?
This varies between providers. We suggest discussing timing directly with the radiology companies. There are approximately ten different providers currently on the Sunshine Coast.
Can you read my imaging in the consultation?
Yes. This involves logging into the specific radiology company's portal and entering your details (full name and date of birth) to locate your images, so it helps to know which company performed the scan. If the provider is not known it can be very difficult to find images, as there are over 300 radiology companies across Australia. Letting reception know in advance helps your imaging load cleanly.
