XXXX Appropriateness Criteria Acute @entity130 to the Knee.

@entity1 @entity174 @entity12169 @entity3031 @entity8043 @entity130
More than 500,000 visits to the emergency room occur annually in the United States, for acute knee @entity130 . Many of these are twisting injuries in young @entity1 who can walk and bear weight, and emergent radiographs are not required. Several clinical decision rules have been devised that can considerably reduce the number of radiographs ordered without missing a clinically significant @entity174 . Although a @entity174 is seen on only 5% of emergency department knee radiographs, 86% of knee @entity174 result from @entity130 . In @entity1 with a fall or twisting injury who have focal tenderness, effusion, or inability to bear weight, radiographs should be the first imaging study obtained. If the radiograph shows no @entity174 , MRI is best for evaluating for a suspected meniscus or ligament tear, or the injuries from a reduced @entity8043 . @entity1 with a @entity3031 should undergo radiographs and an MRI, as well as an angiographic study such as a fluoroscopic, CT, or MR angiogram. The @entity12169 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.
