Henry‐Blake, C, Marshall, M, Treadwell, K, Parmar, S, Higgs, J, Edwards, JJ and Peat, G (2022) The use of plain radiography in diagnosing osteoarthritis: A systematic review and time trend analysis. Musculoskeletal Care. ISSN 1478-2189

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Abstract

Introduction
The National Institute for Health and Care Excellence (NICE) suggest there is no role for routine radiography in the diagnosis of osteoarthritis (OA). It is not known how consistent this recommendation is across international guidelines, or the impact of UK guidance on domestic OA X-ray request rates.

Methods
A systematic search identified guideline recommendations on the role of radiography in OA diagnosis. Full texts underwent dual screening and appraisal using the AGREE II tool. A narrative synthesis was performed. Consultation data were extracted from a UK primary care database: the Consultations in Primary Care Archives (CiPCA). The annual proportion of X-ray requests per 100 OA consulters from 2000 to 2012 were calculated. Joinpoint regression analysis examined if there were changes in the trend of X-ray request rates and compared these with the publication dates of UK guidelines.

Results
Eighteen evidence-based OA guidelines were included in the review. Eleven recommended a clinical diagnosis of OA without radiographic confirmation. Seven recommended routine radiography; these guidelines were predominantly for radiologists. A mean of 17.3 X-rays per 100 patients were requested in patients consulting for OA per year between 2000 and 2012. A statistically significant reduction in X-ray request rates was seen in 2003.

Conclusion
Recommendations on the role of radiography in OA vary between medical specialty and countries. UK guidelines appear to have had a limited impact on X-ray request rates in OA.

Item Type: Article
Additional Information: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.© 2022 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd.
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Depositing User: Symplectic
Date Deposited: 06 Dec 2022 13:45
Last Modified: 06 Dec 2022 13:45
URI: https://eprints.keele.ac.uk/id/eprint/11757

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