ACR Appropriateness Criteria® Chest Pain-Child

Area of Science:

• Pediatric Medicine
• Radiology
• Clinical Guidelines

Background:

• Chest pain is a frequent pediatric complaint with diverse, often benign, causes.
• Evaluation typically occurs in emergency, urgent care, or outpatient settings.
• Diagnostic imaging plays a role in assessing pediatric chest pain.

Purpose of the Study:

• To review clinical scenarios of pediatric chest pain.
• To highlight appropriate initial diagnostic imaging based on evidence and expert consensus.
• To provide guidance for evaluating chest pain in children and adolescents.

Main Methods:

• Review of clinical scenarios including musculoskeletal, pulmonary, cardiac, and psychogenic causes.
• Application of the American College of Radiology Appropriateness Criteria.
• Utilizing evidence-based guidelines and expert consensus, including GRADE methodology.
• Incorporating the RAND/UCLA Appropriateness Method for imaging procedures.

Main Results:

• Discussion of imaging appropriateness for specific conditions like pneumothorax, pulmonary embolism, cardiac disease, and sickle cell disease.
• Identification of imaging recommendations based on available evidence or expert opinion when literature is limited.
• Focus on evidence-based guidelines for diagnostic imaging in pediatric chest pain.

Conclusions:

• Appropriate diagnostic imaging is crucial for evaluating pediatric chest pain.
• Guidelines assist in selecting the most suitable imaging modalities for various clinical presentations.
• This approach supports evidence-based decision-making in pediatric care.