ACR Appropriateness Criteria ® Rib Fractures

Expert Panel on Thoracic Imaging:

Research output: Contribution to journalArticle

Abstract

Rib fractures are the most common thoracic injury after minor blunt trauma. Although rib fractures can produce significant morbidity, the diagnosis of injuries to underlying organs is arguably more important as these complications are likely to have the most significant clinical impact. Isolated rib fractures have a relatively low morbidity and mortality and treatment is generally conservative. As such, evaluation with standard chest radiographs is usually sufficient for the diagnosis of rib fractures, and further imaging is generally not appropriate as there is little data that undiagnosed isolated rib fractures after minor blunt trauma affect management or outcomes. Cardiopulmonary resuscitation frequently results in anterior rib fractures and chest radiographs are usually appropriate (and sufficient) as the initial imaging modality in these patients. In patients with suspected pathologic fractures, chest CT or Tc-99m bone scans are usually appropriate and complementary modalities to chest radiography based on the clinical scenario. 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.

Original languageEnglish (US)
Pages (from-to)S227-S234
JournalJournal of the American College of Radiology
Volume16
Issue number5
DOIs
StatePublished - May 1 2019

Fingerprint

Rib Fractures
Thorax
Wounds and Injuries
Guidelines
Morbidity
Thoracic Injuries
Spontaneous Fractures
Cardiopulmonary Resuscitation
Expert Testimony
Radiology
Radiography
Therapeutics
Bone and Bones
Mortality

Keywords

  • AUC
  • Appropriate Use Criteria
  • Appropriateness Criteria
  • Cardiopulmonary resuscitation
  • Chest CT
  • Chest radiograph
  • Minor blunt trauma
  • Radiography rib views
  • Rib fracture

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

ACR Appropriateness Criteria ® Rib Fractures . / Expert Panel on Thoracic Imaging:.

In: Journal of the American College of Radiology, Vol. 16, No. 5, 01.05.2019, p. S227-S234.

Research output: Contribution to journalArticle

Expert Panel on Thoracic Imaging:. / ACR Appropriateness Criteria ® Rib Fractures In: Journal of the American College of Radiology. 2019 ; Vol. 16, No. 5. pp. S227-S234.
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abstract = "Rib fractures are the most common thoracic injury after minor blunt trauma. Although rib fractures can produce significant morbidity, the diagnosis of injuries to underlying organs is arguably more important as these complications are likely to have the most significant clinical impact. Isolated rib fractures have a relatively low morbidity and mortality and treatment is generally conservative. As such, evaluation with standard chest radiographs is usually sufficient for the diagnosis of rib fractures, and further imaging is generally not appropriate as there is little data that undiagnosed isolated rib fractures after minor blunt trauma affect management or outcomes. Cardiopulmonary resuscitation frequently results in anterior rib fractures and chest radiographs are usually appropriate (and sufficient) as the initial imaging modality in these patients. In patients with suspected pathologic fractures, chest CT or Tc-99m bone scans are usually appropriate and complementary modalities to chest radiography based on the clinical scenario. 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.",
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