ACR Appropriateness Criteria Myelopathy

Roth, Christopher J.; Angevine, Peter D.; Aulino, Joseph M.; Berger, Kevin L.; Choudhri, Asim F.; Fries, Ian Blair; Holly, Langston T.; Kendi, Ayse T.; Kessler, Marcus M.; Kirsch, Claudia; Luttrull, Michael D.; Mechtler, Laszlo; O’Toole, John E.; Sharma, Aseem; Shetty, Vilaas; West, O. Clark; Cornelius, Rebecca S.; Bykowski, Julie

doi:10.1016/j.jacr.2015.10.004

Cited by 14 publications

(10 citation statements)

References 74 publications

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“…There are no detailed guidelines in the setting of thoracic or lumbar spinal trauma. Please see the ACR Appropriateness Criteria Ò topic on "Suspected Spine Trauma" [6] in the setting of additional traumatic symptoms and the ACR Appropriateness Criteria Ò topic on "Myelopathy" [7] if other neurologic symptoms are present.…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

“…Depending on other symptoms associated with ataxia, the site of pathology may be narrowed down to a particular segment or level of the cord, and imaging can be tailored to that site to offer a smaller field of view and more detailed visualization of that particular portion of the cord for detection of even subtle pathology and small lesions. Please also reference the ACR Appropriateness Criteria Ò topic on "Myelopathy" [7] in the appropriate clinical context.…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

“…To avoid delay of appropriate care, any patient with a suspected acute stroke should have imaging guided by the ACR Appropriateness Criteria Ò topic on "Cerebrovascular Disease" [4]. Please also reference the ACR Appropriateness Criteria Ò topic on "Head Trauma" [5], the ACR Appropriateness Criteria Ò topic on "Suspected Spine Trauma" [6], the ACR Appropriateness Criteria Ò topic on "Myelopathy" [7], and the ACR Appropriateness Criteria Ò topic on "Hearing Loss and/or Vertigo" [8] in the appropriate clinical context.…”

Section: Summary Of Literature Reviewmentioning

confidence: 99%

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ACR Appropriateness Criteria® Ataxia

Juliano

Policeni

Agarwal

et al. 2019

Journal of the American College of Radiology

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Ataxia can result from an abnormality in the cerebellum, spinal cord, peripheral nerves, and/or vestibular system. Pathology involving the brain, such as infarct or hydrocephalus, can also present with ataxia as part of the symptom constitution, or result in symptoms that mimic ataxia. Clinical evaluation by history and careful neurological examination is important to help with lesion localization, and helps determine where imaging should be focused. In the setting of trauma with the area of suspicion in the brain, a head CT without intravenous contrast is the preferred initial imaging choice. If vascular injury is suspected, CTA of the neck can be helpful. When the area of suspicion is in the spine, CT or MRI of the spine can be considered to assess for bony or soft-tissue injury, respectively. In the setting of ataxia unrelated to recent trauma, MRI is the preferred imaging modality, tailored to assess the brain or spine depending on the area of suspected pathology. The use of intravenous contrast is generally helpful.

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Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

Section: Summary Of Literature Reviewmentioning

confidence: 99%

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ACR Appropriateness Criteria® Ataxia

Juliano

Policeni

Agarwal

et al. 2019

Journal of the American College of Radiology

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“…Ultimately, clinical suspicion of slowly progressive myelopathy necessitates cross-sectional imaging of the spinal cord, and MR imaging is the preferred modality over computed tomography for this indication. (13,14) The prognosis for SCD patients is largely dependent upon the age and the extent of their clinical disease burden at the time of diagnosis. Patients aged < 50 years with a shorter duration of illness are more likely to have a positive outcome with treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinics in diagnostic imaging (190)

Pearce

Choy

Chen

2018

SMedJ

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A 54-year-old Chinese man presented with a three-month history of progressive gait instability, leg weakness, bilateral ascending lower limb paraesthesias and numbness. The patient had no significant past medical history. Neurologic exam revealed 4/5 strength for knee extension and flexion bilaterally. Dorsiflexion and plantar flexion were rated at 4−/5 bilaterally. In addition, proprioception and vibration were markedly diminished in the lower limbs. Babinski reflex was downgoing bilaterally. Laboratory testing revealed macrocytic mean corpuscular volume (103 fL), low serum B12 levels (98 pmol/L), and increased serum homocysteine (25 µmol/L) and methylmalonic acid (310 nmol/L) levels. Bloodwork was negative for anti-intrinsic factor antibodies. What does the magnetic resonance (MR) image (Fig. 1) show? CMEArticle

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“…After reviewing several guidelines for the diagnosis of thoracolumbar spine injury in adults with trauma, three guidelines were selected (131415). Previous studies recommended an imaging test to confirm thoracolumbar spine injury when any of the following are present: localizing signs of thoracolumbar injury, a neurologic deficit, cervical spine fracture, Glasgow Coma Scale score less than 15 points, major distracting injury, or a history of alcohol or drug addiction (161718).…”

Section: Evidence Summarymentioning

confidence: 99%

Primary Imaging Test for Suspected Traumatic Thoracolumbar Spine Injury: 2017 Guidelines by the Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency

Lee

Hwang

Kim³

et al. 2019

Korean J Radiol

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The Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency developed a primary imaging test for suspected traumatic thoracolumbar spine injury. This guideline was developed using an adaptation process involving collaboration between the development committee and the working group. The development committee, consisting of research methodology experts, established the overall plan and provided support on research methodology. The working group, composed of radiologists with expertise in musculoskeletal imaging, wrote the recommendation. The guidelines recommend that thoracolumbar spine computed tomography without intravenous contrast enhancement be the first-line imaging modality for diagnosing traumatic thoracolumbar spine injury in adults.

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ACR Appropriateness Criteria Myelopathy

Cited by 14 publications

References 74 publications

ACR Appropriateness Criteria® Ataxia

ACR Appropriateness Criteria® Ataxia

Clinics in diagnostic imaging (190)

Primary Imaging Test for Suspected Traumatic Thoracolumbar Spine Injury: 2017 Guidelines by the Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency

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