Abstract
BACKGROUND: Radiological imaging is essential in clinical practice to support diagnosis and treatment planning. As Physical Therapists (PTs) increasingly collaborate within multidisciplinary teams, their ability to interpret radiographs has become more relevant. In Saudi Arabia, limited data exist concerning the involvement of PTs in radiological interpretation. Therefore, this study aimed to explore PTs’ engagement with radiological information, assess their attitudes, and examine the factors influencing their involvement in and interest in imaging education. METHODS: This cross-sectional descriptive study employed a self-structured questionnaire to gather data on demographics, professional characteristics, practice patterns, learning sources, perceived barriers, and attitudes. Chi-square tests were used to assess associations, and binary logistic regression was used to identify predictors of interest in further education. RESULTS: Among the 241 PTs surveyed, 46.1% reported frequent involvement in radiological interpretation, and 83.0% believed it should be part of their professional role. Academic education was the main learning source, while 40.0% identified insufficient training as a key barrier. Engagement levels and attitudes were significantly associated with qualification, experience, workplace setting, and specialization. Notably, PTs who rarely contributed were four times more likely to express interest in further education (OR = 4.0, 95% CI: 1.5–10.4, p = 0.007). CONCLUSION: Many PTs in Saudi Arabia reported engaging in radiological interpretation, though the extent and accuracy of these contributions remain self-reported rather than objectively confirmed. Their involvement was influenced by education, clinical experience, and workplace setting. The findings highlight the need to integrate imaging content into national curricula and continuing professional development programs. Enhancing these competencies has the potential to strengthen collaborative care and may contribute to improved clinical decision-making and healthcare outcomes. CLINICAL TRIAL NUMBER: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-025-08367-1.