Having discussed this over the weekend in Area B, I thought I should check what the current state of play is - and I got a bit of a surprise as things are not quite what I thought they were!
In mid 2013, GPs were authorised to order MRIs for the following conditions in patients < 16 years of age.
- unexplained headache
- unexplained neck or back pain
- internal knee injury
- hip - septic arthritis, slipped femoral epiphysis or Perthe’s disease
- elbow injury- when management may be changed
- suspected scaphoid fracture
In late 2013, they were also authorised to order MRIs in adults with the following conditions (note the absence of back pain in the indication list)
- unexplained seizure
- chronic headache with suspected intracranial pathology
- cervical radiculopathy
- cervical trauma
- acute anterior cruciate ligament or meniscal tears
However, before you rejoice and send everyone back to their GP for the MRI of their neck before clearing the Cx spine, please realise that only certain radiological practices are approved to take GP referrals (see SA list here). Also it looks like there will be some out of pocket costs (looks like as high as $100 for a seizure or knee MRI) and I have no idea what the waiting times/availability might be for the patient.
But the good news is that as GPs can now order certain MRIs in adult patients, you might now want to consider outpatient management of patients who previously were admitted mostly just to get an MRI. If you can, I suggest you talk with the patient's GP about this before doing it.
More info is available from the RACGP here