ACR Appropriateness Criteria® Acutely Limping Child Up To Age 5

Document Type

Article

Publication Date

11-2018

Identifier

DOI: 10.1016/j.jacr.2018.09.030

Abstract

Imaging plays in important role in the evaluation of the acutely limping child. The decision-making process about initial imaging must consider the level of suspicion for infection and whether symptoms can be localized. The appropriateness of specific imaging examinations in the acutely limping child to age 5 years is discussed with attention in each clinical scenario to the role of radiography, ultrasound, nuclear medicine, computed tomography, and magnetic resonance imaging. Common causes of limping such as toddler's fracture, septic arthritis, transient synovitis, and osteomyelitis are discussed. 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.

Journal Title

J Am Coll Radiol

Volume

15

Issue

11S

First Page

252

Last Page

262

MeSH Keywords

Acute Disease; Bone Diseases; Child, Preschool; Diagnosis, Differential; Evidence-Based Medicine; Humans; Infant; Leg; Movement Disorders; Societies, Medical; United States

Keywords

AUC; Appropriate Use Criteria; Appropriateness Criteria; Hip pain; Limping child; Osteomyelitis; Septic arthritis; Toddler’s fracture; Transient synovitis

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