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慢性髋关节疼痛ACR适宜性标准

已有 2005 次阅读 2017-6-11 06:14 |个人分类:临床指南和病例解析|系统分类:观点评述| style, 髋关节, color

慢性髋关节疼痛ACR适宜性标准

慢性髋关节疼痛ACR适宜性标准

1. Radiographs of the pelvis and hip should be the first test ordered for the evaluation of patients with chronic hip pain.
2. MRI hip without IV contrast or US hip is appropriate in patients with chronic hip pain when radiographs are negative, equivocal, or nondiagnostic and there is suspicion for an extraarticular noninfectious soft tissue abnormality such as tendonitis.
3. MRI hip without IV contrast, MR arthrography, or CT arthrography is appropriate in patients with chronic hip pain when radiographs are negative,equivocal, or nondiagnostic and there is a suspicion for impingement.
4. MR arthrography or CT arthrography is appropriate in patients with chronic hip pain when radiographs are negative, equivocal, or nondiagnostic and a labral tear is suspected.
5. MRI hip without IV contrast, MR arthrography, or CT arthrography is appropriate after radiographs in patients with chronic hip pain to evaluate articular cartilage.
6. MRI hip with or without IV contrast or hip aspiration is appropriate after positive radiographs in patients with chronic hip pain with suspected arthritis when infection is a consideration.
7. MRI hip without IV contrast is appropriate in patients with chronic hip pain when radiographs are suggestive of pigmented villonodular synovitis or osteochondromatosis.
8. MRI hip without IV contrast image–guided anesthetic with or without corticosteroid is appropriate to exclude the hip as the source of pain in patients with chronic hip pain and low back, pelvic, or knee pathology with negative or equivocal radiographs or radiographs showing mild osteoarthritis. CT hip without contrast is the preferred modality for computer-navigated surgery.