ACR Appropriateness Criteria® postmenopausal subacute or chronic pelvic pain Journal Article

Authors: Expert Panel on Women's Imaging
Contributor: Vargas, H. A.
Article Title: ACR Appropriateness Criteria® postmenopausal subacute or chronic pelvic pain
Abstract: 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. © 2018 American College of Radiology
Keywords: nuclear magnetic resonance imaging; computer assisted tomography; vagina; vaginism; evidence based practice; ultrasound; echography; pelvis pain syndrome; vulvodynia; menopause; postmenopause; chronic inflammation; abdominal radiography; perineum; appropriateness criteria; hydrosalpinx; pelvis radiography; vulva; vagina atrophy; auc; human; article; doppler ultrasonography; pelvic pain; myofascial pain; vertebral canal stenosis; pelvic inflammatory disease; appropriateness use criteria; pelvic congestion syndrome; vaginal cyst
Journal Title: Journal of the American College of Radiology
Volume: 15
Issue: 11 Suppl.
ISSN: 1546-1440
Publisher: Elsevier Science, Inc.  
Date Published: 2018-11-01
Start Page: S365
End Page: S372
Language: English
DOI: 10.1016/j.jacr.2018.09.023
PUBMED: 30392605
PROVIDER: scopus
Notes: Article -- Export Date: 3 December 2018 -- Source: Scopus
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