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ACR Appropriateness Criteria® Chronic Hand and Wrist Pain: 2023 Update
, J Derek Stensby1, Michael G Fox2
1University of Missouri Health Care, Columbia, Missouri.
Journal of the American College of Radiology : JACR
|June 1, 2024
Summary
Chronic hand and wrist pain evaluation often starts with radiography. Imaging choices depend on patient presentation, physical exam, and differential diagnosis, guided by expert criteria.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- Chronic hand and wrist pain presents a diagnostic challenge due to complex anatomy.
- Numerous potential pain generators exist within the hand and wrist's compact structure.
Purpose of the Study:
- To outline the diagnostic approach for chronic hand and wrist pain.
- To emphasize the role of imaging and modality selection based on clinical factors.
Main Methods:
- Review of patient presentation, physical examination, and differential diagnosis for guiding imaging.
- Application of the American College of Radiology Appropriateness Criteria.
- Utilizing evidence-based methodologies like Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
Main Results:
- Radiography is typically the initial imaging study for chronic hand or wrist pain.
- Imaging modality selection is guided by clinical presentation and differential diagnosis.
- Expert opinion serves as a primary evidence source when literature is limited.
Conclusions:
- A systematic approach, integrating clinical assessment with evidence-based guidelines, is crucial for evaluating chronic hand and wrist pain.
- Appropriate imaging selection optimizes diagnostic yield and patient care.
- The American College of Radiology Appropriateness Criteria provide a framework for evidence-based imaging decisions.
Keywords:
AUCAppropriateness Criteriaappropriate use criteriadiagnostic imaginghand painosteoarthritiswrist instabilityMore Related Videos
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