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ACR Appropriateness Criteria® Right Upper Quadrant Pain: 2022 Update.

Publication ,  Journal Article
Expert Panel on Gastrointestinal Imaging, ; Russo, GK; Zaheer, A; Kamel, IR; Porter, KK; Archer-Arroyo, K; Bashir, MR; Cash, BD; Fung, A; Vij, A ...
Published in: J Am Coll Radiol
May 2023

Acute right upper quadrant pain is one of the most common presenting symptoms in hospital emergency departments, as well as outpatient settings. Although gallstone-related acute cholecystitis is a leading consideration in diagnosis, a myriad of extrabiliary sources including hepatic, pancreatic, gastroduodenal, and musculoskeletal should also be considered. This document focuses on the diagnostic accuracy of imaging studies performed specifically to evaluate acute right upper quadrant pain, with biliary etiologies including acute cholecystitis and its complications being the most common. An additional consideration of extrabiliary sources such as acute pancreatitis, peptic ulcer disease, ascending cholangitis, liver abscess, hepatitis, and painful liver neoplasms remain a diagnostic consideration in the right clinical setting. The use of radiographs, ultrasound, nuclear medicine, CT, and MRI for these indications are discussed. The ACR 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.

Duke Scholars

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

May 2023

Volume

20

Issue

5S

Start / End Page

S211 / S223

Location

United States

Related Subject Headings

  • United States
  • Societies, Medical
  • Pancreatitis
  • Nuclear Medicine & Medical Imaging
  • Magnetic Resonance Imaging
  • Humans
  • Contrast Media
  • Cholecystitis, Acute
  • Acute Disease
  • Abdominal Pain
 

Citation

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Chicago
ICMJE
MLA
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Expert Panel on Gastrointestinal Imaging, ., Russo, G. K., Zaheer, A., Kamel, I. R., Porter, K. K., Archer-Arroyo, K., … Carucci, L. R. (2023). ACR Appropriateness Criteria® Right Upper Quadrant Pain: 2022 Update. J Am Coll Radiol, 20(5S), S211–S223. https://doi.org/10.1016/j.jacr.2023.02.011
Expert Panel on Gastrointestinal Imaging, Laura R., Gregory K. Russo, Atif Zaheer, Ihab R. Kamel, Kristin K. Porter, Krystal Archer-Arroyo, Mustafa R. Bashir, et al. “ACR Appropriateness Criteria® Right Upper Quadrant Pain: 2022 Update.J Am Coll Radiol 20, no. 5S (May 2023): S211–23. https://doi.org/10.1016/j.jacr.2023.02.011.
Expert Panel on Gastrointestinal Imaging, Russo GK, Zaheer A, Kamel IR, Porter KK, Archer-Arroyo K, et al. ACR Appropriateness Criteria® Right Upper Quadrant Pain: 2022 Update. J Am Coll Radiol. 2023 May;20(5S):S211–23.
Expert Panel on Gastrointestinal Imaging, Laura R., et al. “ACR Appropriateness Criteria® Right Upper Quadrant Pain: 2022 Update.J Am Coll Radiol, vol. 20, no. 5S, May 2023, pp. S211–23. Pubmed, doi:10.1016/j.jacr.2023.02.011.
Expert Panel on Gastrointestinal Imaging, Russo GK, Zaheer A, Kamel IR, Porter KK, Archer-Arroyo K, Bashir MR, Cash BD, Fung A, McCrary M, McGuire BM, Shih RD, Stowers J, Thakrar KH, Vij A, Wahab SA, Zukotynski K, Carucci LR. ACR Appropriateness Criteria® Right Upper Quadrant Pain: 2022 Update. J Am Coll Radiol. 2023 May;20(5S):S211–S223.
Journal cover image

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

May 2023

Volume

20

Issue

5S

Start / End Page

S211 / S223

Location

United States

Related Subject Headings

  • United States
  • Societies, Medical
  • Pancreatitis
  • Nuclear Medicine & Medical Imaging
  • Magnetic Resonance Imaging
  • Humans
  • Contrast Media
  • Cholecystitis, Acute
  • Acute Disease
  • Abdominal Pain