2018ACR适宜性标准：慢性手腕疼痛.pdfVIP

APPROPRIATE USE CRITERIA ACR Appropriateness Criteriaâ Chronic Wrist Pain a b Expert Panel on Musculoskeletal Imaging: David A. Rubin, MD , Catherine C. Roberts, MD , Jenny T. Bencardino, MD c d e f , Angela M. Bell, MD , R. Carter Cassidy, MD , Eric Y. Chang, MD , g h i j Soterios Gyftopoulos, MD , Darlene F. Metter, MD , William B. Morrison, MD , Naveen Subhas, MD , k l m n Siddharth Tambar, MD , Jeffrey D. Towers, MD , Joseph S. Yu, MD , Mark J. Kransdorf, MD Abstract Radiographs are indicated as the first imaging test in all patients with chronic wrist pain, regardless of the suspected diagnosis. When radiographs are normal or equivocal, advanced imaging with MRI (without or without intravenous contrast or following arthrography), CT (usually without contrast), and ultrasound each has a role in establishing a diagnosis. Furthermore, these examinations may contribute to staging disease, treatment planning, and prognostication, even when radiographs are diagnostic of a specific condition. Which examination or examinations are best depends on the specific location of pain and the clinically suspected conditions. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical cond