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Shoulder Pain Appropriate Use Criteria

UC Shoulder Pain AUC (pdf)

Priority Clinical Area Coverage

This AUC reasonably addresses common and important clinical scenarios within the "Shoulder pain" Priority Clinical Area (PCA) and thus meets the minimum requirement for qCDSM to cover that PCA. However, by CMS definition of relevancy, it is not considered relevant to that PCA, as further described (See AUC Overview).

Search Strategy and Sources – Completed 2023-04-25

  • Limits:  English, 15 years publication, and adult, 19+
  • Extensive PubMed (Medline), Supplemental: EMBase, Web of Science, and Cochrane Database of Systematic Review.

( Shoulder  Pain AND diagnostic imaging(major) AND investigative technique(major)   OR
Shoulder  AND diagnostic imaging AND investigative technique AND review/document type) OR
{Shoulder pain AND diagnostic imaging  OR shoulder/diagnostic imaging (major) )

AND 

(practice guidelines as topic OR decision support techniques OR sensitivity and specificity OR predictive value of tests OR evidence based medicine)

Results

180 publications were examined by team leaders. 85 references were determined to be relevant and submitted to the team for grading. The result are 24 references for the AUC. 

Shoulder AUC References and OCEBM Level of Evidence 

  1. Amini, B., et al., ACR Appropriateness Criteria((R)) Shoulder Pain-Traumatic. J Am Coll Radiol, 2018. 15(5s): p. S171-s188. Level 3
  2. Anderson, S.E., et al., Magnetic resonance imaging of bone tumors and joints. Top Magn Reson Imaging, 2007. 18(6): p. 457-65. Level 5
  3. Bradley, M.P., G. Tung, and A. Green, Overutilization of shoulder magnetic resonance imaging as a diagnostic screening tool in patients with chronic shoulder pain. J Shoulder Elbow Surg, 2005. 14(3): p. 233-7. Level 4
  4. Charousset, C., et al., Accuracy of CT arthrography in the assessment of tears of the rotator cuff. J Bone Joint Surg Br, 2005. 87(6): p. 824-8. Level 4
  5. Cortes, A, et al.,  A value-based care analysis of magnetic resonance imaging in patients with suspected rotator cuff tendinopathy and the implicated role of conservative management. J Shoulder Elbow Surg (20190 28, 2153-2160. Level 4
  6. de Abreu, M.R., et al., Acromioclavicular joint osteoarthritis: comparison of findings derived from MR imaging and conventional radiography. Clin Imaging, 2005. 29(4): p. 273-7. Level 3
  7. Demehri, S., N. Hafezi-Nejad, and E.K. Fishman, Advanced imaging of glenohumeral instability: the role of MRI and MDCT in providing what clinicians need to know. Emerg Radiol, 2017. 24(1): p. 95-103. Level 5
  8. Filippucci, E., et al., Ultrasound imaging for the rheumatologist. XLVII. Ultrasound of the shoulder in patients with gout and calcium pyrophosphate deposition disease. Clin Exp Rheumatol, 2013. 31(5): p. 659-64. Level 2
  9. Frei, R., et al., Arthroscopic evaluation of ultrasonography and magnetic resonance imaging for diagnosis of rotator cuff tear. Ortop Traumatol Rehabil, 2008. 10(2): p. 111-4.
  10. Friedman, M.V., et al., Impact of Shoulder Sonography on Clinical Decision Making. J Ultrasound Med, 2017. 36(7): p. 1365-1371. Level 4
  11. Gaigneux, E., et al., Ultrasound abnormalities in septic arthritis are associated with functional outcomes. Joint Bone Spine, 2017. 84(5): p. 599-604. Level 3
  12. Hayashi, D., et al., Imaging in Osteoarthritis. Radiol Clin North Am, 2017. 55(5): p. 1085-1102. Level 5
  13. Hussain, A., et al., Effectiveness Of Plain Shoulder Radiograph In Detecting Degenerate Rotator Cuff Tears. J Ayub Med Coll Abbottabad, 2018. 30(1): p. 8-11. Level 4
  14. Iagnocco, A., et al., Sonographic study of painful shoulder. Clin Exp Rheumatol, 2003. 21(3): p. 355-8. Level 2
  15. Iqbal, H.J., et al., Diagnostic value of MR arthrogram in SLAP lesions of the shoulder. Surgeon, 2010. 8(6): p. 303-9. Level 4
  16. Kim, A.C., et al., Acromioclavicular joint injuries and reconstructions: a review of expected imaging findings and potential complications. Emerg Radiol, 2012. 19(5): p. 399-413. Level 4
  17. Kim, J.Y., J.S. Park, and Y.G. Rhee, Can Preoperative Magnetic Resonance Imaging Predict the Reparability of Massive Rotator Cuff Tears? Am J Sports Med, 2017. 45(7): p. 1654-1663. Level 4
  18. Lenza, M., et al., Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Database Syst Rev, 2013(9): p. Cd009020. Level 3
  19. Mohtadi, N.G., et al., A prospective, double-blind comparison of magnetic resonance imaging and arthroscopy in the evaluation of patients presenting with shoulder pain. J Shoulder Elbow Surg, 2004. 13(3): p. 258-65. Level 1
  20. Okoroha, K.R., et al., Characterization of Rotator Cuff Tears: Ultrasound Versus Magnetic Resonance Imaging. Orthopedics, 2017. 40(1): p. e124-e130. Level 4
  21. Potter, H.G., et al., Magnetic resonance imaging after total hip arthroplasty: evaluation of periprosthetic soft tissue. J Bone Joint Surg Am, 2004. 86(9): p. 1947-54. Level 2
  22. Sherman, S.L., et al., Overuse of Magnetic Resonance Imaging in the Diagnosis and Treatment of Moderate to Severe Osteoarthritis. Iowa Orthop J, 2018. 38: p. 33-37. Level 2
  23. Tang, H., S. Ahlawat, and L.M. Fayad, Multiparametric MR Imaging of Benign and Malignant Bone Lesions. Magn Reson Imaging Clin N Am, 2018. 26(4): p. 559-569. Level 5
  24. van Kampen, D.A., et al., Diagnostic value of patient characteristics, history, and six clinical tests for traumatic anterior shoulder instability. J Shoulder Elbow Surg, 2013. 22(10): p. 1310-9. Level 3
  25. Weishaupt, D. and M.E. Schweitzer, MR imaging of septic arthritis and rheumatoid arthritis of the shoulder. Magn Reson Imaging Clin N Am, 2004. 12(1): p. 111-24, vii. Level 3