ACR Appropriateness Criteria® Plexopathy: 2021 Update

Area of Science:

• Radiology
• Neurology
• Medical Imaging

Background:

• Plexopathy, affecting brachial or lumbosacral nerves, stems from diverse causes like trauma, neoplasms, and autoimmune diseases.
• Accurate diagnosis is crucial for effective management of these debilitating conditions.

Framework:

• Plexus MRI is identified as the most appropriate initial imaging modality for both brachial and lumbosacral plexopathy.
• Guidelines address imaging strategies for nontraumatic, traumatic, and malignancy-associated plexopathies.

Implementation:

• The American College of Radiology Appropriateness Criteria provide evidence-based guidelines for imaging procedures.
• A multidisciplinary expert panel reviews and updates these guidelines annually based on medical literature analysis.
• Methodologies like RAND/UCLA and GRADE are employed to assess imaging appropriateness.

Implications:

• This approach ensures optimal initial imaging selection for plexopathy, improving diagnostic accuracy.
• Standardized guidelines facilitate consistent and evidence-based patient care.
• Expert opinion supplements evidence in equivocal cases, ensuring comprehensive evaluation.