ACR Appropriateness Criteria® Rib Fractures

被引:19
|
作者
Henry, Travis S. [1 ]
Kirsch, Jacobo [2 ]
Kanne, Jeffrey P. [5 ]
Chung, Jonathan H. [6 ]
Donnelly, Edwin F. [7 ]
Ginsburg, Mark E. [8 ]
Heitkamp, Darel E. [11 ]
Kazerooni, Ella A. [12 ]
Ketai, Loren H. [13 ]
McComb, Barbara L. [3 ]
Parker, J. Anthony [14 ]
Ravenel, James G. [15 ]
Restrepo, Carlos Santiago [16 ]
Saleh, Anthony G. [9 ]
Shah, Rakesh D. [10 ]
Steiner, Robert M. [17 ]
Suh, Robert D. [18 ]
Mohammed, Tan-Lucien H. [4 ]
机构
[1] Emory Univ Hosp, Atlanta, GA 30322 USA
[2] Cleveland Clin, Weston, FL USA
[3] Mayo Clin, Jacksonville, FL 32224 USA
[4] Univ Florida, Coll Med, Gainesville, FL USA
[5] Univ Wisconsin, Dept Radiol, Sch Med & Publ Hlth, Madison, WI 53706 USA
[6] Natl Jewish Hlth, Denver, CO USA
[7] Vanderbilt Univ, Med Ctr, Nashville, TN USA
[8] Columbia Univ, Dept Surg, Soc Thorac Surg, New York, NY USA
[9] New York Methodist Hosp, Amer Coll Chest Phys, Brooklyn, NY USA
[10] N Shore Univ Hosp, Manhasset, NY USA
[11] Indiana Univ, Dept Radiol, Indianapolis, IN 46204 USA
[12] Univ Michigan, Med Ctr, Dept Radiol, Ann Arbor, MI 48109 USA
[13] Univ New Mexico, Dept Radiol, Albuquerque, NM 87131 USA
[14] Beth Israel Deaconess Med Ctr, Dept Radiol, Soc Nucl Med & Mol Imaging, Boston, MA 02215 USA
[15] Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA
[16] Univ Texas Hlth Sci Ctr San Antonio, Dept Radiol, San Antonio, TX 78229 USA
[17] Temple Univ, Philadelphia, PA 19122 USA
[18] Ronald Regan UCLA Med Ctr, Los Angeles, CA USA
关键词
rib fracture; chest radiograph; ribs; trauma; Appropriateness Criteria; CARDIOPULMONARY-RESUSCITATION; COMPUTED-TOMOGRAPHY; CHEST; DIFFERENTIATION; RADIOGRAPHY; SECONDARY; TRAUMA;
D O I
10.1097/RTI.0000000000000113
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Rib fracture is the most common thoracic injury, present in 10% of all traumatic injuries and almost 40% of patients who sustain severe nonpenetrating trauma. Although rib fractures can produce significant morbidity, the diagnosis of associated complications (such as pneumothorax, hemothorax, pulmonary contusion, atelectasis, flail chest, cardiovascular injury, and injuries to solid and hollow abdominal organs) may have a more significant clinical impact. When isolated, rib fractures have a relatively low morbidity and mortality, and failure to detect isolated rib fractures does not necessarily alter patient management or outcome in uncomplicated cases. A standard posteroanterior chest radiograph should be the initial, and often the only, imaging test required in patients with suspected rib fracture after minor trauma. Detailed radiographs of the ribs rarely add additional information that would change treatment, and, although other imaging tests (eg, computed tomography, bone scan) have increased sensitivity for detection of rib fractures, there are little data to support their use. The American College of Radiology 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 process 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.
引用
收藏
页码:364 / 366
页数:3
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