Therapy intervention and imaging utilisation patterns for patients over the age of 50 presenting to a chiropractic teaching clinic.

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An audit of all consultations for patients 50 years and over spanning 2005-2010 was undertaken. Management of patients was categorised according to treatment delivery (yes/no); treatment type (passive care with/without SMT); spinal region (cervical/thoracic/lumbo-pelvic); whether imaging was obtained (yes/no); image timing (prior to care yes/no); and imaging centre (MUCC/external). This study aims to quantify the imaging patterns and practices at a chiropractic teaching clinic and its significance with respect to spinal manipulation. The use of imaging within the chiropractic profession is the subject of significant debate, and especially the question of whether spinal manipulation should be performed in the absence of spinal imaging of the relevant spinal region. There has been, to date little data on the actual frequency of the use of imaging for patients undergoing chiropractic care. Whilst there is not universal agreement as to the significance of age, it does constitute an ideal starting point, a baseline to quantitatively measure imaging behaviour in a clinical setting. This study sets out with the primary clinical question; "How often do students at a chiropractic teaching clinic view images of the region being treated with high velocity low amplitude (HVLA) manipulation of the spine if the patient is age 50 or greater?" A second question is; "If images were viewed, were they obtained prior to HVLA treatment?" Finally "If images were obtained, were they performed on campus or externally, or both

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