Aipedia: Osteopaths and chiropractors

Using AI to read X-ray and MRI reports in osteopathic and chiropractic practice

Aipedia, by the Apex broking team · Last reviewed 2026-10-30

AI can help you summarise a radiology report or flag features on an image, but interpreting imaging must stay within your training and competence. A summary that drops a reported finding can turn into a missed pathology claim.

Part of: AI in osteopaths and chiropractors

In short

Some chiropractors take or request X-rays, and many osteopaths and chiropractors receive MRI or X-ray reports from patients. Generative AI tools can summarise those reports, and image-analysis software can highlight features on films. OPS B2 requires osteopaths to work within the limits of their training and competence, and the GOsC says AI output must be checked for hallucinations and that tools may need MHRA approval. A summary that leaves out an incidental finding, or software that misses one, does not move responsibility away from the practitioner who acts on it.

How practitioners use AI with imaging

Three uses come up most often. First, pasting or uploading a radiologist's report into a generative AI chatbot to get a plain-English summary for the patient or the notes. Second, using image-analysis software that measures angles or highlights features on spinal X-rays. Third, asking a chatbot what a particular finding means for treatment. The first is the most common and looks harmless, but it has two problems: the report contains identifiable health data, and a summary can drop or soften a finding the radiologist flagged for follow-up.

The duties that apply

Several existing duties apply to this work:

Competence: OPS B1 and B2 require appropriate knowledge and working within the limits of your training. Image interpretation beyond your training should be left to a radiologist or referred.
Checking output: the GOsC guidance warns that AI can produce inaccurate output and present it as fact.
Device status: software that analyses images to inform diagnosis may be a medical device. The GOsC tells osteopaths to check approval with the MHRA.
Confidentiality: OPS D5 and UK GDPR; the GOsC says putting confidential data into free public AI tools would likely breach confidentiality.
Safety: OPS C4 requires action to keep patients from harm, including acting on findings that need onward referral.

Chiropractors are bound by the GCC Code; the GCC has not issued AI guidance.

What can go wrong

Illustrative scenario: a patient brings an MRI report for their lumbar spine. The practitioner uses a generative AI chatbot to summarise it. The summary covers the disc findings in detail but omits a short line at the end recommending further investigation of an unrelated incidental finding. The practitioner treats the back pain and files the summary rather than the report. Months later the patient learns that the follow-up was never arranged and alleges that the practitioner should have told them and their GP.

Similar problems arise when image software misses a feature such as a possible fracture or lesion, or when a practitioner adopts a chatbot's explanation of a finding that is plainly wrong.

Referral duties

When a report or image contains a finding outside your scope, the safe course is to discuss it with the patient, record that you did, and write to their GP or the referring clinician. Do not rely on a summary to decide whether a finding is significant. Read the original report in full, especially the conclusion and any recommendations. See AI-drafted referral letters to GPs for the letter itself, and AI red-flag screening for serious pathology at intake.

How PI usually responds

A missed or delayed diagnosis claim is a classic professional negligence claim, and the GOsC and GCC indemnity rules require cover for negligent acts, errors or omissions with a £5m aggregate minimum. Cover is usually written for the services you describe to your insurer. If you interpret imaging yourself, or take X-rays, make sure that is disclosed and within your policy's description of your activities; an insurer could otherwise argue it was not part of the risk presented. Several delayed diagnosis claims from one flawed tool could erode a single aggregate limit, so consider whether the minimum is enough.

Practical controls

Useful controls include:

Always read the original report; treat AI summaries as an aid, never a replacement.
Do not paste identifiable reports into free public tools.
Check the regulatory status of any image-analysis software.
Refer findings outside your competence and record the referral.
Tell your insurer if you take or interpret imaging.

How Apex helps

Apex arranges PI for osteopaths and chiropractors, including those who request or take imaging, and a broker can check that imaging work is properly described to insurers. Read chiropractors' PI and the GCC rules.

Sources

Frequently asked

Can I use AI to explain an MRI report to my patient?

You can use it as a drafting aid, but read the original report in full and check the summary against it, especially the conclusion and recommendations. Do not paste identifiable reports into free public AI tools, which the GOsC says would likely breach confidentiality.

Am I responsible if AI image software misses a fracture?

If you relied on it to make a clinical decision, a patient is likely to look to you. The GOsC says responsibility for AI use cannot be outsourced to the developer. Use such software only within your competence and check its regulatory status.

Do I need to tell my insurer if I take or interpret X-rays?

Yes, you should describe your services accurately, including any imaging you take or interpret. Cover is written for the activities presented to the insurer, and leaving out imaging could cause problems if a related claim arises.

What should I do with an incidental finding on a report?

Discuss it with the patient, record the discussion and write to their GP or the referring clinician. Do not rely on an AI summary to decide whether it matters. Acting on findings that need onward care is part of keeping patients from harm.

Check your PI covers how you use AI

Tell us about your firm and the work you do. A broker will review how your current PI treats AI-assisted work, or arrange new cover. No fee for a quote. Or call 0117 325 0027.

Start a PI quote Request a callback

Apex Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales, company number 07014570. This page is general information about how AI is used in the profession and how insurance may respond. It is not legal, regulatory or insurance advice on your circumstances, and it does not guarantee that cover will be available or on what terms.