title: ACR Appropriateness Criteria® Acute Pelvic Pain in the Reproductive Age Group.
abstract: Acute pelvic pain in premenopausal women frequently poses a diagnostic dilemma. These patients may exhibit nonspecific signs and symptoms such as nausea, vomiting and leukocytosis. The cause of pelvic pain includes a myriad of diagnostic possibilities such as obstetric, gynecologic, urologic, gastrointestinal, and vascular etiologies. The choice of the imaging modality is usually determined by a suspected clinical differential diagnosis. Thus the patient should undergo careful evaluation and the suspected differential diagnosis should be narrowed before an optimal imaging modality is chosen. Transvaginal and transabdominal pelvic sonography is the modality of choice, to assess for pelvic pain, when an obstetric or gynecologic etiology is suspected and computed tomography is often more useful when gastrointestinal or genitourinary pathology is thought to be more likely. Magnetic resonance imaging, when available in the acute setting, is favored over computed tomography for assessing pregnant patients for nongynecologic etiologies owing to its lack of ionizing radiation.The American College of Radiology Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every three 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 where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors.affiliation: *University of Texas MD Anderson Cancer Center, Houston, Texas; †Rambam Healthcare Campus, Haifa, Israel; ‡Toronto General Hospital, Toronto, Ontario, Canada; §Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; ∥New York University Medical Center, New York, New York; ¶Northwestern University Prentice Women's Hospital, Chicago, Illinois; #Massachusetts General Hospital, Boston, Massachusetts; **McGill University, Montreal, Quebec, Canada; ††Massachusetts General Hospital, Boston, Massachusetts; ‡‡Brigham & Women's Hospital, Boston, Massachusetts, American College of Obstetrics and Gynecology; §§Columbia Presbyterian Medical Center, New York, New York, American College of Obstetrics and Gynecology; ∥∥The University of Vermont Medical Center, Burlington, Vermont; ¶¶Brigham & Women's Hospital, Boston, Massachusetts; ##Mayo Clinic, Rochester, Minnesota; ***Valley Hospital, Ridgewood, New Jersey, American College of Obstetrics and Gynecology; and †††Sunnybrook Health Sciences Centre, Bayview Campus, Toronto, Ontario, Canada.
authors.forename: Priyadarshani R
authors.initials: PR
authors.lastname: Bhosale
authors.forename: Marcia C
authors.initials: MC
authors.lastname: Javitt
authors.forename: Mostafa
authors.initials: M
authors.lastname: Atri
authors.forename: Robert D
authors.initials: RD
authors.lastname: Harris
authors.forename: Stella K
authors.initials: SK
authors.lastname: Kang
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Meyer
authors.forename: Pari V
authors.initials: PV
authors.lastname: Pandharipande
authors.forename: Caroline
authors.initials: C
authors.lastname: Reinhold
authors.forename: Gloria M
authors.initials: GM
authors.lastname: Salazar
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Shipp
authors.forename: Lynn
authors.initials: L
authors.lastname: Simpson
authors.forename: Betsy L
authors.initials: BL
authors.lastname: Sussman
authors.forename: Jennifer
authors.initials: J
authors.lastname: Uyeda
authors.forename: Darci J
authors.initials: DJ
authors.lastname: Wall
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Zelop
authors.forename: Phyllis
authors.initials: P
authors.lastname: Glanc
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D017699:Pelvic Pain / Q000000981:diagnostic imaging*; D012955:Societies, Medical; D014057:Tomography, X-Ray Computed / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods; D014481:United States; D014621:Vagina / Q000000981:diagnostic imaging