Hospital for Special Surgery, New York, New York.
Panel Chair, Program Director, Diagnostic Radiology, Mayo Clinic Arizona, Phoenix, Arizona.
J Am Coll Radiol. 2023 May;20(5S):S33-S48. doi: 10.1016/j.jacr.2023.02.019.
Chronic hip pain is a frequent chief complaint for adult patients who present for evaluation in a variety of clinical practice settings. Following a targeted history and physical examination, imaging plays a vital role in elucidating the etiologies of a patient's symptoms, as a wide spectrum of pathological entities may cause chronic hip pain. Radiography is usually the appropriate initial imaging test following a clinical examination. Depending on the clinical picture, advanced cross-sectional imaging may be subsequently performed for further evaluation. This documents provides best practice for the imaging workup of chronic hip pain in patients presenting with a variety of clinical scenarios. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
慢性髋部疼痛是成年患者就诊于各种临床环境时常见的主要主诉。在进行有针对性的病史和体格检查后,影像学在阐明患者症状的病因方面起着至关重要的作用,因为广泛的病理实体可能导致慢性髋部疼痛。放射摄影通常是临床检查后的适当初始影像学检查。根据临床表现,可能随后进行高级的横断面成像以进行进一步评估。本文档为在各种临床情况下出现的慢性髋部疼痛患者的影像学检查提供了最佳实践。美国放射学会的适宜性标准是针对特定临床情况的循证指南,每年由多学科专家小组进行审查。指南的制定和修订包括对同行评议期刊上的现有医学文献进行广泛分析,并应用成熟的方法(RAND/UCLA 适宜性方法和推荐评估、制定和评估分级或 GRADE)来评估特定临床情况下影像学和治疗程序的适宜性。在证据不足或存在争议的情况下,专家意见可以补充现有证据,以推荐影像学检查或治疗。