Canadian Association of Radiologists Musculoskeletal System Diagnostic Imaging Referral Guideline

Area of Science:

• Radiology
• Clinical Guideline Development
• Musculoskeletal Medicine

Background:

• The Canadian Association of Radiologists (CAR) convened an expert panel to address variability in musculoskeletal imaging referrals.
• A systematic review of existing referral guidelines was necessary to inform evidence-based recommendations.

Purpose of the Study:

• To develop 124 evidence-based recommendation statements for musculoskeletal imaging across 25 clinical scenarios.
• To provide guidance on imaging for diverse musculoskeletal conditions, including pain, infection, tumors, and arthropathies.

Main Methods:

• A systematic rapid scoping review of 41 guidelines (50 publications) was conducted.
• The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework was utilized for guideline development.
• Expert panel consensus was achieved for 124 recommendation statements.

Main Results:

• Recommendations were generated for 25 distinct musculoskeletal clinical/diagnostic scenarios.
• The guideline covers a broad spectrum of conditions including pain, infection, tumors, arthropathies, metabolic bone disease, stress injuries, orthopedic hardware, avascular necrosis/bone infarction, and complex regional pain syndrome.

Conclusions:

• This guideline offers standardized, evidence-based recommendations for musculoskeletal imaging referrals.
• Implementation of these recommendations is expected to optimize diagnostic imaging utilization and improve patient management in musculoskeletal care.