title: Appropriateness of knee MRI prescriptions: clinical, economic and technical issues.
abstract: OBJECTIVE
  Many studies show that a large portion of medical prescriptions for diagnostic examinations may be not useful for patient's management or unnecessary. Rapid technological advancement has made it possible for magnetic resonance imaging (MRI) to be increasingly used all over the world, particularly for musculoskeletal disorders. The aim of this study was to assess the appropriateness of the knee MRI prescriptions.
  
  
  METHODS
  A panel of experts found standard clinical practice guidelines in the management of knee disorders. Secondly, the finalized set of guidelines chosen was compared with the data of 400 patients who underwent previous knee MRIs, which were then reported in a specific questionnaire prepared by the authors. The rate of appropriateness of knee MRI prescriptions was then calculated.
  
  
  RESULTS
  Almost 21% of prescriptions were totally inappropriate, 18.8% were uncertain, and 60.2% could be considered totally appropriate. The most frequent prescription indication was for meniscal disorders that account for 26.8% of the total indications.
  
  
  CONCLUSIONS
  Our results demonstrate that approximately 40% of the total prescriptions were totally inappropriate or uncertain and that most of these were made by general practitioners. In light of these results, the economic impact of inappropriate prescriptions on the Italian healthcare system has to be seriously considered.
authors.affiliation: Radiologia e Diagnostica per Immagini, I.R.C.C.S-Istituto Dermosifilopatico di Santa Maria e San Gallicano, I.F.O., Via Elio Chianesi 53, Rome, Italy.
authors.forename: F M
authors.initials: FM
authors.lastname: Solivetti
authors.affiliation: Radiologia e Diagnostica per Immagini, I.R.C.C.S-Istituto Dermosifilopatico di Santa Maria e San Gallicano, I.F.O., Via Elio Chianesi 53, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Guerrisi
authors.affiliation: Ortopedia, Regina Elena National Cancer Institute - Roma, Via Elio Chianesi 53, Rome, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Salducca
authors.affiliation: Radiologia e Diagnostica per Immagini, I.R.C.C.S-Istituto Dermosifilopatico di Santa Maria e San Gallicano, I.F.O., Via Elio Chianesi 53, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Desiderio
authors.affiliation: Reumatologia, I.R.C.C.S-Istituto Dermosifilopatico di Santa Maria e San Gallicano, I.F.O., Via Elio Chianesi 53, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Graceffa
authors.affiliation: Dipartimento di Scienze Radiologiche, ASP di Siracusa, C.so Gelone 17, Syracusa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Capodieci
authors.affiliation: Unità Operativa Diagnostica per Immagini, ASP di Messina, Via La farina 263/n, Messina, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Romeo
authors.affiliation: Direzione Scientifica, Regina Elena National Cancer Institute - Roma, Via Elio Chianesi 53, Rome, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Sperduti
authors.affiliation: Radiologia e Diagnostica per Immagini, Regina Elena National Cancer Institute - Roma, Via Elio Chianesi 53, Rome, Italy. canitano@ifo.it.|, Viale Mazzini 144, 00195, Rome, Italy. canitano@ifo.it.
authors.forename: S
authors.initials: S
authors.lastname: Canitano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000473:pathology*; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000191:economics; D008297:Male; D008875:Middle Aged; D055656:Prescriptions / Q000191:economics; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Appropriateness criteria; Knee MRI; MR prescriptions