ACR Appropriateness Criteria® Sudden Onset of Cold, Painful Leg: 2023 Update.
Publication Title
J Am Coll Radiol
Document Type
Article
Publication Date
11-1-2023
Keywords
washington; swedish; Humans; Arterial Occlusive Diseases; Ischemia; Leg; Lower Extremity; Pain; Societies, Medical; United States
Abstract
Acute onset of a cold, painful leg, also known as acute limb ischemia, describes the sudden loss of perfusion to the lower extremity and carries significant risk of morbidity and mortality. Acute limb ischemia requires rapid identification and the management of suspected vascular compromise and is inherently driven by clinical considerations. The objectives of initial imaging include confirmation of diagnosis, identifying the location and extent of vascular occlusion, and preprocedural/presurgical planning. 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 process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
Clinical Institute
Cardiovascular (Heart)
Specialty/Research Institute
Cardiology
Specialty/Research Institute
Emergency Medicine
Specialty/Research Institute
Diagnostic Imaging
DOI
10.1016/j.jacr.2023.08.012 http
