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J Am Coll Radiol. 2015 Mar;12(3):221-7. doi: 10.1016/j.jacr.2014.11.015.

ACR Appropriateness Criteria acute trauma to the ankle.

Author information

1
Penn State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address: tmosher@hmc.psu.edu.
2
Mayo Clinic, Phoenix, Arizona.
3
New York University Center for Musculoskeletal Care, New York, New York.
4
Warwick Valley Orthopedic Surgery, Warwick, New York; American Academy of Orthopaedic Surgeons, Rosemont, Illinois.
5
Univeristy of Kentucky, Lexington, Kentucky.
6
Penn State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania.
7
Texas Scottish Rite Hospital, Dallas, Texas.
8
American Academy of Orthopaedic Surgeons, Rosemont, Illinois; Bone, Spine and Hand Surgery, Chartered, Brick, NJ.
9
Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
10
Brigham & Women's Hospital, Boston, Massachusetts.
11
University of Wisconsin Hospital, Madison, Wisconsin.
12
Tufts Medical Center, Boston, Massachusetts.
13
Thomas Jefferson University, Philadelphia, Pennsylvania.

Abstract

Acute ankle injuries are frequently diagnosed and treated in emergency departments and outpatient clinics. Recent evidence-based clinical treatment guidelines and systematic review of economic analyses support the use of 3-view (anteroposterior, lateral, and mortise) radiographic evaluation of patients meeting the criteria of the Ottawa ankle rules. Cross-sectional imaging has a limited secondary role primarily as a tool for preoperative planning and as a problem-solving technique in patients with persistent symptoms and suspected of having occult fractures. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 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.

KEYWORDS:

Appropriateness Criteria; ankle; diagnosis; fracture; guidelines; trauma

PMID:
25743919
DOI:
10.1016/j.jacr.2014.11.015
[Indexed for MEDLINE]

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