ACR Appropriateness Criteria Acute Trauma to the Knee

Michael J. Tuite, Mark J. Kransdorf, Francesca D. Beaman, Ronald S. Adler, Behrang Amini, Marc Appel, Stephanie A. Bernard, Molly E. Dempsey, Ian Blair Fries, Bennett S. Greenspan, Bharti Khurana, Timothy J. Mosher, Eric A. Walker, Robert J. Ward, Daniel E. Wessell, Barbara N. Weissman

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

More than 500,000 visits to the emergency room occur annually in the United States, for acute knee trauma. Many of these are twisting injuries in young patients who can walk and bear weight, and emergent radiographs are not required. Several clinical decision rules have been devised that can considerably reduce the number of radiographs ordered without missing a clinically significant fracture. Although a fracture is seen on only 5% of emergency department knee radiographs, 86% of knee fractures result from blunt trauma. In patients with a fall or twisting injury who have focal tenderness, effusion, or inability to bear weight, radiographs should be the first imaging study obtained. If the radiograph shows no fracture, MRI is best for evaluating for a suspected meniscus or ligament tear, or the injuries from a reduced patellar dislocation. Patients with a knee dislocation should undergo radiographs and an MRI, as well as an angiographic study such as a fluoroscopic, CT, or MR angiogram. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures, by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)1164-1172
Number of pages9
JournalJournal of the American College of Radiology
Volume12
Issue number11
DOIs
StatePublished - Jan 1 2015

Fingerprint

Knee
Wounds and Injuries
Hospital Emergency Service
Patellar Dislocation
Knee Dislocation
Guidelines
Weights and Measures
Expert Testimony
Ligaments
Angiography
Therapeutics

Keywords

  • Appropriateness criteria
  • CT
  • MRI
  • diagnostic imaging
  • knee injury
  • radiograph

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Tuite, M. J., Kransdorf, M. J., Beaman, F. D., Adler, R. S., Amini, B., Appel, M., ... Weissman, B. N. (2015). ACR Appropriateness Criteria Acute Trauma to the Knee. Journal of the American College of Radiology, 12(11), 1164-1172. https://doi.org/10.1016/j.jacr.2015.08.014

ACR Appropriateness Criteria Acute Trauma to the Knee. / Tuite, Michael J.; Kransdorf, Mark J.; Beaman, Francesca D.; Adler, Ronald S.; Amini, Behrang; Appel, Marc; Bernard, Stephanie A.; Dempsey, Molly E.; Fries, Ian Blair; Greenspan, Bennett S.; Khurana, Bharti; Mosher, Timothy J.; Walker, Eric A.; Ward, Robert J.; Wessell, Daniel E.; Weissman, Barbara N.

In: Journal of the American College of Radiology, Vol. 12, No. 11, 01.01.2015, p. 1164-1172.

Research output: Contribution to journalArticle

Tuite, MJ, Kransdorf, MJ, Beaman, FD, Adler, RS, Amini, B, Appel, M, Bernard, SA, Dempsey, ME, Fries, IB, Greenspan, BS, Khurana, B, Mosher, TJ, Walker, EA, Ward, RJ, Wessell, DE & Weissman, BN 2015, 'ACR Appropriateness Criteria Acute Trauma to the Knee', Journal of the American College of Radiology, vol. 12, no. 11, pp. 1164-1172. https://doi.org/10.1016/j.jacr.2015.08.014
Tuite MJ, Kransdorf MJ, Beaman FD, Adler RS, Amini B, Appel M et al. ACR Appropriateness Criteria Acute Trauma to the Knee. Journal of the American College of Radiology. 2015 Jan 1;12(11):1164-1172. https://doi.org/10.1016/j.jacr.2015.08.014
Tuite, Michael J. ; Kransdorf, Mark J. ; Beaman, Francesca D. ; Adler, Ronald S. ; Amini, Behrang ; Appel, Marc ; Bernard, Stephanie A. ; Dempsey, Molly E. ; Fries, Ian Blair ; Greenspan, Bennett S. ; Khurana, Bharti ; Mosher, Timothy J. ; Walker, Eric A. ; Ward, Robert J. ; Wessell, Daniel E. ; Weissman, Barbara N. / ACR Appropriateness Criteria Acute Trauma to the Knee. In: Journal of the American College of Radiology. 2015 ; Vol. 12, No. 11. pp. 1164-1172.
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