As an ortho nurse practitioner, we are usually in a position in which we have to read xrays, MRIs, or even CT scans right away. It can be an intimidating feeling, but I am here to give you a few pointers and resources to help you feel more confident in your ability to read images.
Let me also preface this by saying, it make a HUGE difference in who your collaborative physician is. I lucked out with THE best! He is VERY knowledgeable, kind, and he LOVES to teach. I can honestly attest that if he wasn’t my teacher, I wouldn’t have this passion for othro like I do. LOVE YOU TONS Dr. Melancon!!!
I’ve been an ortho NP now for 3 years AND there is still ALOT for me to learn. I am not in the surgical setting, but I do have to know surgical procedures for post-op follow-ups. My patient population usually includes urgent care type fractures or fracture follow-ups from the ER.
Imaging Studies:
There are a TON of imaging studies on the market. The ones that we use mostly in my orthopaedic care setting are xrays, CTs, MRIs, and at times DEXA scans.
For xrays, I have to be able to read my own xrays unless my collaborative physician is in the office that day with me. Then, if I am uncertain or I need to bounce something off of him I can. Otherwise, if I am uncertain about a scenario, I will call the on- call orthopaedic surgeon in our group. I have absolutely NO shame in asking for help, in fact, my physicians like that I ask them for help. I am only 3 years in, BUT I am really eager to learn as much as I can on my own because orthopaedics is my passion.
With CTs and MRIs, patients usually have it done outside the office and bring the images on a disc. Some times the images come with a radiologist reading. Here is a VERY important tip for you: DO NOT RELY SOLY ON THE READING . I have found that when reading advanced imaging studies, the reader is very subjective. Meaning, that his or her expertise may not be your expertise, so things may be missed or called that isn’t there on the actual images in the report. That is why it is so important that you know what is normal so you can easily spot what isn’t. After I go through the disc of images, I do read the report just to make sure we both are on the same page.
DEXA scans are usually a primary care provider’s cup of tea, but I find it easier to catch because, lets be honest, people rarely go to the doctors nowadays unless something is really bothering them. Hence, a fracture, so we catch the fracture, treat the patient, but then we have to questions the mechanism of action. If the fracture occurred at a standing height, does the patient have poor bones? And that is where, for the bigger picture, we at least check to see the bone density. There is a GREAT program from the American Association of Orthopaedic Surgeons that I will mention later.
Resources:
Here are some of my all time, tried and true, favorite resources for guided self-learning on advanced imaging studies. I HIGHLY suggest going through a general orthopaedic learning course first because it will make the advanced imaging readings easer to understand. I have listed 2 books in which I have on hand in clinic under my other blog here.
Let us get right into it!
- MRI and CT imaging learning:
- DEXA scans / Osteoporosis course by AAOS
I am a visual learner so having it on a YouTube format makes it sooo much easier for me to follow along. Plus, these two sites, the speakers are not monotoned (PTSD from nursing school, eh). So, they keep my interest!
Good luck in yalls adventure out there! Leave a comment if you have any questions 🙂
