Can a Physiotherapist Refer You for an MRI, Ultrasound or X-ray?

You hurt your knee playing football, or your shoulder has been nagging since you started swimming again. You see a physiotherapist, privately or through your GP surgery, and after an examination they say a scan would help. Can they arrange it themselves, or do you now need a GP appointment to get the referral?

The answer is yes in more cases than people expect, but it is not the same for every scan. MRI and ultrasound are one thing; X-ray and CT, which use radiation, follow a different set of rules. This guide covers the NHS route, the private route, and what to check before you go ahead.

The short answer

A physiotherapist can refer you for an MRI or ultrasound at many private clinics, because those scans do not use ionising radiation and the clinic sets its own referral policy. For X-ray and CT, the Ionising Radiation (Medical Exposure) Regulations 2017 require a referrer working within the imaging provider's procedures; physiotherapists can be entitled to refer, but whether a particular clinic accepts a particular physio depends on that clinic. On the NHS, it depends on the service and the rights the physio's organisation has given them.

In every case the request is a question put to a radiology team, not an order. A radiologist or sonographer decides whether the scan is justified and can suggest a different test.

Physiotherapists on the NHS

The NHS says physiotherapy is free on the NHS, although there may be a long waiting list, and that in many areas you can get it from NHS community musculoskeletal services without a GP referral. It also says some GP surgeries have physiotherapists who specialise in bone and joint problems, and that they may refer you to a specialist if needed.

Those first contact physiotherapists are the ones most likely to arrange a scan. A role description for first contact physiotherapists, hosted on NHS England's e-learning platform, says they request investigations, such as X-rays, and referrals to help with diagnosis. The Chartered Society of Physiotherapy's guidance on first contact physiotherapy and radiology says requesting plain X-rays, ultrasound or MRI scans as part of physiotherapy practice is within the profession's scope, provided the physiotherapist is educated, trained and competent, has completed any local training, and is registered with the local radiology department as a non-medical referrer.

So in an NHS setting the practical answer is: ask. Your physiotherapist will know whether they can request the scan directly or whether it goes through the GP.

Private physiotherapists and private MRI or ultrasound

If you are seeing a private physiotherapist, the question is whether a private imaging clinic will accept their referral. For MRI and ultrasound the answer at many clinics is yes, and some will scan you on self-referral in any case. The NHS says an MRI scan takes detailed pictures of the inside of your body and is used to help find the cause of symptoms and plan treatment, and that an ultrasound scan is used to see images of the inside of your body, such as muscles and organs. Neither uses ionising radiation, so the radiation regulations do not apply and the clinic's own policy decides.

What the clinic will want is a short referral letter saying what the physio found and what question the scan should answer. That is worth having even where self-referral is allowed, because a radiologist with a clear clinical question writes a more useful report. Ask the clinic to send the report to the physiotherapist and to your GP. Our guide to private MRI without a GP referral covers the self-referral route.

Why X-ray and CT are different

X-ray, CT, DEXA and mammography use ionising radiation, and every such exposure in the UK falls under the Ionising Radiation (Medical Exposure) Regulations 2017. Regulation 10 sets out the duties of the practitioner, operator and referrer, including that the referrer must supply the practitioner with enough medical information to decide whether the exposure is justified. Regulation 11 requires each individual exposure to be justified before it happens.

The imaging provider's procedures say which professions can act as referrers. The CSP notes that organisations may require non-medical referrers to complete learning related to these regulations before receiving referral rights. In practice a physiotherapist can refer you for an X-ray at a clinic that has entitled physiotherapists as referrers, and cannot at one that has not; the clinic will tell you which. Our guide to X-rays without a referral explains why an entitled referrer is always needed for these scans.

A good physio will not always refer

A physiotherapist who does not send you for a scan is often doing the right thing. The NHS tendonitis page says a mild tendon injury should feel better within 2 to 3 weeks and describes physiotherapy as one of the treatments if it does not improve; it does not mention scans at all. Many soft-tissue injuries are treated with a loading and strengthening programme that a scan would not change. Our guides to knee MRI and seeing a GP before a scan explain when imaging adds something. If your physiotherapist says a scan is not needed yet, ask what would change their mind.

How to check a physiotherapist is registered

The NHS says that if you choose private physiotherapy, you should choose a physiotherapist who is chartered, with MCSP after their name, and registered with the Health and Care Professions Council. The HCPC's Check the Register page lets you search by surname or registration number and filter by profession. Private imaging clinics will usually ask for the physio's HCPC number on the referral.

The same check applies in reverse: GOV.UK says private clinics must register with the Care Quality Commission in England or Healthcare Inspectorate Wales in Wales. Our guide to radiographers and radiologists explains who does what once you are there.

What to ask, and how FindScan fits in

When you contact a clinic, ask whether it accepts referrals from physiotherapists for the scan you need, what the referral letter must include, and whether the report can go to the physio and your GP. You can compare MRI clinics and ultrasound clinics near you on FindScan and send an enquiry; the clinic contacts you to confirm the referral it needs and the next steps.

FindScan is a directory of independent, regulated imaging clinics: you compare clinics and send an enquiry, and the clinic contacts you. We are not a healthcare provider and nothing here replaces an examination by a physiotherapist or GP. If an injury comes with numbness or weakness that is spreading, a joint you cannot put weight on, or severe pain that is getting worse, the NHS says NHS 111 can help if you think you need medical help right now, and 999 is for life-threatening emergencies.