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Related Concept Videos

Ultrasonography01:17

Ultrasonography

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Ultrasonography is an imaging technique that uses high-frequency sound waves to visualize the body's internal structures. It is a non-invasive and safe procedure that does not involve the use of ionizing radiation, making it widely used in various medical fields. Ultrasonography is used to study heart function, blood flow in the neck or extremities, certain conditions such as gallbladder disease, and fetal growth and development.
During an ultrasonography procedure, a handheld device called...
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A Novel Application of Musculoskeletal Ultrasound Imaging
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Optimizing Musculoskeletal Imaging Referrals: Making Wise Choices a Knee-Jerk Reaction.

Natalia Gorelik1, Courtney R Green2, Candyce Hamel2,3

  • 1Department of Diagnostic Radiology, McGill University, Montreal, QC, Canada.

Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes
|May 27, 2025
PubMed
Summary
This summary is machine-generated.

Choosing Wisely Canada (CWC) developed new musculoskeletal imaging guidelines. These recommendations aim to reduce overuse by prioritizing ultrasound for rotator cuff issues and limiting MRIs for osteoarthritis and femoroacetabular impingement.

Keywords:
Choosing Wiselyappropriate utilizationdiagnostic pathwaysmusculoskeletal imagingrecommendationsreferral guidelines

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Area of Science:

  • Radiology
  • Musculoskeletal Imaging
  • Evidence-Based Medicine

Background:

  • Musculoskeletal (MSK) imaging overuse is a concern.
  • Updated guidelines are needed to optimize diagnostic imaging referrals.
  • Choosing Wisely Canada (CWC) promotes appropriate test utilization.

Purpose of the Study:

  • To develop CWC recommendations for MSK imaging.
  • To align with the 2024 Canadian Association of Radiologists (CAR) MSK referral guidelines.
  • To address overuse in MSK diagnostic imaging.

Main Methods:

  • A multidisciplinary Steering Committee guided development.
  • A two-round Delphi method was employed for consensus.
  • Top 3 impactful scenarios from CAR guidelines were selected.

Main Results:

  • Recommendation 1: Consider ultrasound before MRI for rotator cuff pathology/bursitis.
  • Recommendation 2: Avoid hip/knee MRI for >mild osteoarthritis on X-ray unless specialist advised.
  • Recommendation 3: Avoid hip MRI for femoroacetabular impingement on X-ray without clinical signs.

Conclusions:

  • Disseminates updated MSK imaging guideline recommendations via knowledge translation.
  • Strengthens collaboration between CAR and CWC.
  • Establishes a reproducible consensus approach for future CWC imaging recommendations.
  • Supports value-based radiology and optimized resource use.