ACR Appropriateness Criteria Myelopathy

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

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Patients presenting with myelopathic symptoms may have a number of causative intradural and extradural etiologies, including disc degenerative diseases, spinal masses, infectious or inflammatory processes, vascular compromise, and vertebral fracture. Patients may present acutely or insidiously and may progress toward long-term paralysis if not treated promptly and effectively. Noncontrast CT is the most appropriate first examination in acute trauma cases to diagnose vertebral fracture as the cause of acute myelopathy. In most nontraumatic cases, MRI is the modality of choice to evaluate the location, severity, and causative etiology of spinal cord myelopathy, and predicts which patients may benefit from surgery. Myelopathy from spinal stenosis and spinal osteoarthritis is best confirmed without MRI intravenous contrast. Many other myelopathic conditions are more easily visualized after contrast administration. Imaging performed should be limited to the appropriate spinal levels, based on history, physical examination, and clinical judgment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review 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.

Original languageEnglish (US)
Pages (from-to)38-44
Number of pages7
JournalJournal of the American College of Radiology
Volume13
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Spinal Cord Diseases
Spine Osteoarthritis
Spinal Diseases
Guidelines
Spinal Stenosis
Expert Testimony
Paralysis
Physical Examination
Blood Vessels
Spinal Cord
Consensus
History
Wounds and Injuries
Therapeutics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Roth, C. J., Angevine, P. D., Aulino, J. M., Berger, K. L., Choudhri, A. F., Fries, I. B., ... Bykowski, J. (2016). ACR Appropriateness Criteria Myelopathy. Journal of the American College of Radiology, 13(1), 38-44. https://doi.org/10.1016/j.jacr.2015.10.004

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 Tuba Karaqulle; Kessler, Marcus M.; Kirsch, Claudia F.; Luttrull, Michael D.; Mechtler, Laszlo L.; O'Toole, John E.; Sharma, Aseem; Shetty, Vilaas S.; West, O. Clark; Cornelius, Rebecca S.; Bykowski, Julie.

In: Journal of the American College of Radiology, Vol. 13, No. 1, 01.01.2016, p. 38-44.

Research output: Contribution to journalArticle

Roth, CJ, Angevine, PD, Aulino, JM, Berger, KL, Choudhri, AF, Fries, IB, Holly, LT, Kendi, ATK, Kessler, MM, Kirsch, CF, Luttrull, MD, Mechtler, LL, O'Toole, JE, Sharma, A, Shetty, VS, West, OC, Cornelius, RS & Bykowski, J 2016, 'ACR Appropriateness Criteria Myelopathy', Journal of the American College of Radiology, vol. 13, no. 1, pp. 38-44. https://doi.org/10.1016/j.jacr.2015.10.004
Roth, Christopher J. ; Angevine, Peter D. ; Aulino, Joseph M. ; Berger, Kevin L. ; Choudhri, Asim F. ; Fries, Ian Blair ; Holly, Langston T. ; Kendi, Ayse Tuba Karaqulle ; Kessler, Marcus M. ; Kirsch, Claudia F. ; Luttrull, Michael D. ; Mechtler, Laszlo L. ; O'Toole, John E. ; Sharma, Aseem ; Shetty, Vilaas S. ; West, O. Clark ; Cornelius, Rebecca S. ; Bykowski, Julie. / ACR Appropriateness Criteria Myelopathy. In: Journal of the American College of Radiology. 2016 ; Vol. 13, No. 1. pp. 38-44.
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