The role of imaging in osteoarthritis.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest The authors have no conflicts of interest. 14. J Am Coll Radiol. 2022 Nov;19(11S):S329-S340. doi: 10.1016/j.jacr.2022.09.016. ACR Appropriateness Criteria® Hernia. Expert Panel on Gastrointestinal Imaging; Garcia EM(1), Pietryga JA(2), Kim DH(3), Fowler KJ(4), Chang KJ(5), Kambadakone AR(6), Korngold EK(7), Liu PS(8), Marin D(9), Moreno CC(10), Panait L(11), Santillan CS(12), Weinstein S(13), Wright CL(14), Zreloff J(15), Carucci LR(16). Author information: (1)Virginia Tech Carilion School of Medicine, Roanoke, Virginia; Board Member, Taubman Museum of Art. Electronic address: emgarcia@carilionclinic.org. (2)Division Chief, Emergency Radiology at UNC Chapel Hill, Chapel Hill North Carolina; and University of Alabama at Birmingham, Birmingham, Alabama. (3)Panel Chair, University of Wisconsin Hospital & Clinics, Madison, Wisconsin; and Vice-Chair of Education, University of Wisconsin Department of Radiology. (4)Panel Vice-Chair, University of California San Diego, San Diego, California; Chair ACR LI-RADS; Division Chief, SAR Portfolio Director, RSNA Radiology Senior Deputy Editor. (5)Boston University Medical Center, Boston, Massachusetts; Section Chief of Abdominal Imaging, Director of MRI, Chair of Committee on C-RADS. (6)Massachusetts General Hospital, Boston, Massachusetts; Division Chief, Abdominal Imaging, Massachusetts General Hospital and Medical Director, Martha's Vineyard Hospital Imaging. (7)Section Chief, Body Imaging/Chair, Department of Radiology Promotion and Tenure Committee; Oregon Health and Science University, Portland, Oregon. (8)Section Head, Abdominal Imaging, Cleveland Clinic, Cleveland, Ohio. (9)Duke University Medical Center, Durham, North Carolina. (10)Division Director, Abdominal Imaging Division, Emory University, Atlanta, Georgia. (11)President, Minnesota Hernia Center, Minneapolis, Minnesota; American College of Surgeons; American Hernia Society (member of the Technology and Value Assessment Committee); Practice Advisory Committee Member, American Hernia Society. (12)Vice-Chair of Clinical Operations, Department of Radiology, University of California San Diego, San Diego, California. (13)University of California San Francisco, San Francisco, California. (14)The Ohio State University Wexner Medical Center, Columbus, Ohio. (15)Georgia, Primary Care Physician, Emory University, Atlanta, Georiga; Medical Director, Seavey General Medicine Clinic; Assistant Director of Innovation Seavey Comprehensive Internal Medicine Clinic, Emory University, Atlanta, Georgia. (16)Specialty Chair, Virginia Commonwealth University Medical Center, Richmond, Virginia; Section Chief Abdominal Imaging, Director of MRI and CT. Abdominopelvic hernias are common clinical entities composed of a wide variety of congenital, traumatic, and iatrogenic etiologies. Any weakness in the body wall may result in hernia of cavity contents with concomitant risks of morbidity and mortality. Presentations may be specific, palpable body wall mass/bulge, or vague, nonspecific pain through bowel obstruction. This document focuses on initial imaging of the adult population with signs of symptoms prompting suspicion of abdominopelvic hernia. Imaging of the abdomen and pelvis to evaluate defects is essential for prompt diagnosis and treatment. Often CT and ultrasound are the first-line modalities to quickly evaluate the abdomen and pelvis, providing for accurate diagnoses and management of patients. MRI protocols may be useful as first-line imaging studies, especially in patients with orthopedic instrumentation. Although often performed, abdominal radiographs and fluorographic procedures may provide indirect evidence of hernias but are usually not indicated for initial diagnosis of hernia. The ACR 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 in which peer-reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation. Copyright © 2022 American College of Radiology. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jacr.2022.09.016