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AAOS Now

Published 12/1/2009

ACR appropriateness criteria now available

New radiology guidelines developed with help of AAOS members

AAOS members were instrumental in developing the latest version of the American College of Radiography’s (ACR) Appropriateness Criteria (AC) that was released Sept. 30, 2009. These evidence-based guidelines help physicians and other providers make the most appropriate imaging or treatment decision for a given clinical condition.

Ian Blair Fries, MD, and William Kenneth Payne III, MD, participated on the musculoskeletal imaging panel; Peter D. Pizzutillo, MD, was on the pediatric imaging panel; and Alan W. Yasko, MD, served on the radiation oncology bone metastases panel.

The latest recommendations are primarily evidence-based and supported by available recent literature, according to Drs. Fries and Pizzutillo.

“A lot of time was spent on developing these guidelines. I believe they are worthwhile and certainly the product of an impressive group of physicians,” said Dr. Fries.

In all, more than 60 physicians from specialties outside of radiology and radiation oncology participated in the development and review process that resulted in 64 updated or new topics. The new release also includes updated Relative Radiation Level (RRL) information for the imaging exams. All RRL assignments are based on reviews of the current literature and the experience of medical physicists and radiologists.

“AAOS members need to be informed of the ACR appropriateness criteria to maintain a current base of knowledge that is derived from the orthopaedic literature as well as that of other disciplines, such as radiology,” said Dr. Pizzutillo. “The daily interaction and common patient care concerns that exist between orthopaedic surgeons and radiologists would support this recommendation.”

The updated guidelines are available for free for individual users on the ACR Web site, www.acr.org, and will soon be accessible on iPhone, BlackBerry®, Palm® handheld devices, personal digital assistant, smart phone, or similar handheld electronic devices. Those interested in the criteria for more systematic or institutional use should contact the ACR for permission and licensing information.