caa a22 4500 605459460 CHVBK 20210128100234.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00167-014-3003-8 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3003-8 The utility of plain radiographs in the initial evaluation of knee pain amongst sports medicine patients [Elektronische Daten] [Michael Alaia, Omar Khatib, Mehul Shah, Joseph A. Bosco, Laith M. Jazrawi, Eric Strauss] Purpose: To evaluate whether screening radiographs as part of the initial workup of knee pain impacts clinical decision-making in a sports medicine practice. Methods: A questionnaire was completed by the attending orthopaedic surgeon following the initial office visit for 499 consecutive patients presenting to the sports medicine centre with a chief complaint of knee pain. The questionnaire documented patient age, duration of symptoms, location of knee pain, associated mechanical symptoms, history of trauma within the past 2weeks, positive findings on plain radiographs, whether magnetic resonance imaging was ordered, and whether plain radiographs impacted the management decisions for the patient. Patients were excluded if they had prior X-rays, history of malignancy, ongoing pregnancy, constitutional symptoms as well as those patients with prior knee surgery or intra-articular infections. Statistical analyses were then performed to determine which factors were more likely do correspond with diagnostic radiographs. Results: Overall, initial screening radiographs did not change management in 72% of the patients assessed in the office. The mean age of patients in whom radiographs did change management was 57.9years compared to 37.1years in those patients where plain radiograph did not change management (p<0.0001). Plain radiographs had no impact on clinical management in 97.3% of patients younger than 40. In patients whom radiographs did change management, radiographs were more likely to influence management if patients were over age forty, had pain for over 6months, had medial or diffuse pain, or had mechanical symptoms. A basic cost analysis revealed that the cost of a clinically useful radiographic series in a patient under 40years of age was $7,600, in contrast to $413 for a useful series in patients above the age of 40. Conclusion: Data from the current study support the hypothesis that for the younger patient population, routine radiographic imaging as a screening tool may be of little clinical benefit. Factors supporting obtaining screening radiographs include age greater than 40, knee pain for greater than 6months, the presence of medial or diffuse knee pain, and the presence of mechanical symptoms. Level of evidence: II. Springer-Verlag Berlin Heidelberg, 2014 Knee pain nationallicence Radiographs nationallicence Healthcare economics nationallicence Alaia Michael Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut Khatib Omar Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut Shah Mehul Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut A. Bosco Joseph Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut M. Jazrawi Laith Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut Strauss Eric Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/8(2015-08-01), 2213-2217 0942-2056 23:8<2213 2015 23 167 https://doi.org/10.1007/s00167-014-3003-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3003-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Alaia Michael Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- Khatib Omar Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- Shah Mehul Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- A. Bosco Joseph Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- M. Jazrawi Laith Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- Strauss Eric Division of Sports Medicine, NYU Hospital for Joint Diseases, 333 East 38th Street, 4th Floor, 10016, New York, NY, USA aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/8(2015-08-01), 2213-2217 0942-2056 23:8<2213 2015 23 167