医学
肩袖
肩锁关节
适当的使用标准
物理疗法
分级(工程)
体格检查
慢性疼痛
盂唇
肩关节
颈部疼痛
唇
医学物理学
关节镜检查
物理医学与康复
放射科
外科
病理
替代医学
土木工程
工程类
内科学
作者
Nicholas C. Nacey,Michael G. Fox,Donna G. Blankenbaker,Doris Chen,Matthew A. Frick,Shari T. Jawetz,Ross Mathiasen,Noah Raizman,Kavita H Rajkotia,Nicholas Said,J. Derek Stensby,Naveen Subhas,Devaki Shilpa Surasi,Eric A. Walker,Eric Y. Chang
标识
DOI:10.1016/j.jacr.2023.02.017
摘要
Chronic shoulder pain is an extremely common presenting complaint. Potential pain generators include the rotator cuff tendons, biceps tendon, labrum, glenohumeral articular cartilage, acromioclavicular joint, bones, suprascapular and axillary nerves, and the joint capsule/synovium. Radiographs are typically the initial imaging study obtained in patients with chronic shoulder pain. Further imaging may often be required, with modality chosen based on patient symptoms and physical examination findings, which may lead the clinician to suspect a specific pain generator. 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 process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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