ACR Appropriateness Criteria(R) Stress (Fatigue/Insufficiency) Fracture, Including Sacrum, Excluding Other Vertebrae
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
UMass Chan Affiliations
Department of RadiologyDocument Type
Journal ArticlePublication Date
2017-05-01
Metadata
Show full item recordAbstract
Stress fractures, including both fatigue and insufficiency types, are frequently encountered in clinical practice as a source of pain in both athletes and patients with predisposing conditions. Radiography is the imaging modality of choice for baseline diagnosis. MRI has greatly improved our ability to diagnose radiographically occult stress fractures. Tc-99m bone scan and CT may also be useful as diagnostic tools. Although fatigue and insufficiency fractures can be self-limited and go onto healing even without diagnosis, there is usually value in initiating prompt therapeutic measures as incomplete stress fractures have the potential of progressing to completion and requiring more invasive treatment or delay in return to activity. This is particularly important in the setting of stress fractures of the femoral neck. Accuracy in the identification of these injuries is also relevant because the differential diagnosis includes entities that would otherwise be treated significantly different (ie, osteoid osteoma, osteomyelitis, and metastasis). The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.Source
J Am Coll Radiol. 2017 May;14(5S):S293-S306. doi: 10.1016/j.jacr.2017.02.035. Link to article on publisher's siteDOI
10.1016/j.jacr.2017.02.035Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48209PubMed ID
28473086Notes
Full author list omitted for brevity. For the full list of authors, see article.
Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.jacr.2017.02.035