Radiology

Clinical decision tools have been developed to aid in the diagnosis and management of injuries commonly sustained during sporting events. Tools that have been appropriately validated in populations outside the initial study population can assist sports medicine physicians in the decision of when to get radiographs from the sidelines.

The current literature suggests that clinical symptoms such as pain level and disability, are not reliably correlated with radiographic findings of degenerative joint disease in the spine

Essential Literature

THE ACCURACY OF DIAGNOSTIC ULTRASOUND IMAGING FOR MUSCULOSKELETAL SOFT TISSUE PATHOLOGY OF THE EXTREMITIES: A COMPREHENSIVE REVIEW OF THE LITERATURE.
Henderson et. al. 2015
Conclusion:
A total of 207 individual studies were included. The results show that MSK-DUSI has acceptable diagnostic accuracy for a wide spectrum of musculoskeletal conditions of the extremities. However, there is a lack of high quality prospective experimental studies in this area and as such clinicians should interpret the results with some caution due to the potential for overestimation of diagnostic accuracy.

VALIDATION OF THE OTTAWA ANKLE RULES FOR ACUTE  FOOT AND ANKLE INJURIES
David S. et. al. 2015
Conclusion:
When applied during the first hour following injury the OARs significantly overestimate the need for radiographs. However, a negative finding  rules out the need to obtain radiographs. It appears the AT’s decision-making based on the totality of the examination findings is the best filter in determining referral for radiographs.

THE CORRELATION OF RADIOGRAPHIC FINDINGS AND PATIENT SYMPTOMATOLOGY IN CERVICAL DEGENERATIVE JOINT DISEASE
Iris Sun Rudy et. al. 2015
Conclusion:
The results of this study indicate that clinical symptoms such as pain level, headaches, shoulder referral and hand radiculopathy or numbness are not reliably correlated with radiographic findings of degenerative joint disease in the cervical spine. A small increase in diagnostic accuracy between the presence of neck stiffness and all forms of cervical degenerative joint disease is shown, however, this increase is not at the level expected to change clinical practice.

buy cheap viagra http://deeprootsmag.org/2013/07/23/the-women-composers/ It’s known as the World’s Strongest Acai. discount on cialis Impotence can be caused by either physical or psychological problems. This is the very reason that Arginine is recommended often to gym enthusiasts and people suffering from heart diseases. the best viagra Stress and depression http://deeprootsmag.org/2012/09/07/breathe-deep-the-intoxicating-fragrance/ viagra uk cause erectile dysfunction to the man.  

EFFECT OF ROUTINE DIAGNOSTIC IMAGING FOR PATIENTS WITH MUSCULOSKELETAL DISORDERS: A META-ANALYSIS
Karel et. al. 2015
Conclusion:
These results strengthen the available evidence that routine referral to diagnostic imaging by general practitioners for patients with knee and low back pain yields little to no benefit.

EFFECTIVENESS OF INTERVENTIONS DESIGNED TO REDUCE THE USE OF IMAGING FOR LOW-BACK PAIN: A SYSTEMATIC REVIEW
Jenkins et. al. 2015
Conclusion:
Clinical decision support in a hospital setting and targeted reminders to primary care doctors were effective interventions in reducing the use of imaging for low-back pain. These are potentially low-cost interventions that would substantially decrease medical expenditures associated with the management of low-back pain.

SIDELINE COVERAGE: WHEN TO GET RADIOGRAPHS? A REVIEW OF CLINICAL DECISION TOOLS
Gould et. al. 2014
Conclusion:
Clinical decision tools have been developed to aid in the diagnosis and management of injuries commonly sustained during sporting events. Tools that have been appropriately validated in populations outside the initial study population can assist sports medicine physicians in the decision of when to get radiographs from the sidelines.

THE OTTAWA KNEE RULES – A USEFUL CLINICAL DECISION TOOL
Yao et. al. 2012
Conclusion:
The Ottawa knee rules are a valuable tool for clinicians in the routine management of acute knee injuries. Studies show that they are highly sensitive at identifying patients with fractures of the knee and have a high degree of interobserver agreement and reproducible results. Application of the Ottawa knee rules in appropriate clinical scenarios may reduce the number of unnecessary radiographs ordered, streamlining patient throughput and allowing for significant cost savings. Although designed for use in adults, some studies have suggested that the Ottawa knee rules may also be applicable to the paediatric population.

CANADIAN CERVICAL SPINE RULE COMPARED WITH COMPUTED TOMOGRAPHY: A PROSPECTIVE ANALYSIS
Duane et. al. 2011
Conclusion:
Canadian Cervical Spine Rule is very sensitive but not very specific to determine the need for radiographic evaluation after blunt trauma. Based on this study, the rule should be streamlined to improve specificity while maintaining sensitivity.