ACR Appropriateness Criteria® Postmenopausal Subacute or Chronic Pelvic Pain
| Autor: | Tara L. Henrichsen, Elizabeth A. Sadowski, Liina Poder, Phyllis Glanc, Kika M. Dudiak, Therese M. Weber, Sandeep Deshmukh, Hebert Alberto Vargas, Esma A Akin, Katherine E. Maturen, Mark Dassel, Edward R. Oliver, Thomas C. Winter, Lee A Learman |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
030219 obstetrics & reproductive medicine business.industry Pelvic pain Chronic pain Guideline medicine.disease Pelvic congestion syndrome 030218 nuclear medicine & medical imaging Perineum 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Pelvic inflammatory disease medicine Vulvodynia Radiology Nuclear Medicine and imaging Radiology medicine.symptom business Hydrosalpinx |
| Zdroj: | Journal of the American College of Radiology. 15:S365-S372 |
| ISSN: | 1546-1440 |
| DOI: | 10.1016/j.jacr.2018.09.023 |
| Popis: | Pelvic pain is common in both reproductive age and postmenopausal women, and the major etiologies change throughout the life cycle. Chronic pain is defined as lasting for at least 6 months. There are many gastrointestinal and urinary disorders associated with chronic pain in this age group, which are not discussed in this guideline. Pain may be localized to the deep pelvis, with potential causes including pelvic congestion syndrome, intraperitoneal adhesions, hydrosalpinx, chronic inflammatory disease, or cervical stenosis. Ultrasound is the initial imaging modality of choice, while CT and MRI may be appropriate for further characterization of sonographic findings. Alternatively, pain may be localized to the vagina, vulva, or perineum, with potential causes including vaginal atrophy, vaginismus, vaginal or vulvar cysts, vulvodynia, or pelvic myofascial pain. Imaging is primarily indicated in context of an abnormal physical exam and ultrasound is the initial modality of choice, while MRI may be appropriate for further characterization in select cases. 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. |
| Databáze: | OpenAIRE |
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