ACR Appropriateness Criteria acute trauma to the ankle.
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.
Penn State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address: tmosher@hmc.psu.edu.
Timothy J
TJ
Mosher
Mayo Clinic, Phoenix, Arizona.
Mark J
MJ
Kransdorf
New York University Center for Musculoskeletal Care, New York, New York.
Ronald
R
Adler
Warwick Valley Orthopedic Surgery, Warwick, New York; American Academy of Orthopaedic Surgeons, Rosemont, Illinois.
Marc
M
Appel
Univeristy of Kentucky, Lexington, Kentucky.
Francesca D
FD
Beaman
Penn State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Stephanie A
SA
Bernard
Penn State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Michael A
MA
Bruno
Texas Scottish Rite Hospital, Dallas, Texas.
Molly E
ME
Dempsey
American Academy of Orthopaedic Surgeons, Rosemont, Illinois; Bone, Spine and Hand Surgery, Chartered, Brick, NJ.
Ian Blair
IB
Fries
Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Viviane
V
Khoury
Brigham & Women's Hospital, Boston, Massachusetts.
Bharti
B
Khurana
Mayo Clinic, Phoenix, Arizona.
Catherine C
CC
Roberts
University of Wisconsin Hospital, Madison, Wisconsin.
Michael J
MJ
Tuite
Tufts Medical Center, Boston, Massachusetts.
Robert J
RJ
Ward
Thomas Jefferson University, Philadelphia, Pennsylvania.
Adam C
AC
Zoga
Brigham & Women's Hospital, Boston, Massachusetts.
Barbara N
BN
Weissman
D064386:Ankle Fractures / Q000000981:diagnostic imaging*; D016512:Ankle Injuries / Q000000981:diagnostic imaging*; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic; D011859:Radiography / Q000592:standards*; D011871:Radiology / Q000592:standards*; D014481:United States
Appropriateness Criteria; ankle; diagnosis; fracture; guidelines; trauma