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Don’t order a hip MRI when x-rays demonstrate osteoarthritis and symptoms are suggestive of osteoarthritis as the MRI rarely adds useful information to guide diagnosis or treatment.
Choosing Wisely Canada
Canadian Orthopaedic Assoc., Canadian Arthroplasty Soc. & Arthroscopy Assoc. of Canada
The diagnosis of hip osteoarthritis can be effectively made based upon the patient’s history, physical examination and plain radiography. Ordering MRI scans incurs further waiting times for patients, can cause unnecessary anxiety while waiting for specialist consultation, and can delay MRI imaging for appropriate patients.
ver más ... 2018Don’t order a knee MRI when weight-bearing x-rays demonstrate osteoarthritis and symptoms are suggestive of osteoarthritis as the MRI rarely adds useful information to guide diagnosis or treatment.
Choosing Wisely Canada
Canadian Orthopaedic Assoc., Canadian Arthroplasty Soc. & Arthroscopy Assoc. of Canada
The diagnosis of knee osteoarthritis can be effectively made based upon the patient’s history, physical examination, and plain radiography consisting of weight-bearing posterior-anterior, lateral and skyline views. Ordering MRI scans incurs further waiting times for patients, can cause unnecessary anxiety while waiting.
ver más ... 2018Don’t use arthroscopic debridement as a primary treatment in the management of osteoarthritis of the knee.
Choosing Wisely Canada
Canadian Orthopaedic Assoc., Canadian Arthroplasty Soc. & Arthroscopy Assoc. of Canada
Several recent meta-analyses have culminated in clinical practice guidelines recommending against the use of arthroscopic debridement for the treatment of degenerative knee arthritis and meniscal tears in patients over the age of 35, as it appears there is no maintained benefit of arthroscopic surgery over conservative management (exercise therapy, injections, and drugs). However, this does not preclude the judicious use of arthroscopic surgery when indicated to manage symptomatic co-existing ...
ver más ... 2018Don’t use a q2h turning routine unless it meets the older person’s plan of care.
Choosing Wisely Canada
Canadian Nurses Association & Canadian Gerontological Nursing Association
Individualized turning plans should be developed to align with the older person’s care needs. Turning an older person q2h is often considered the gold standard implemented in many areas of health care to aid in the avoidance of skin breakdown and pressure injuries. However, there is little evidence to support this particular frequency of repositioning. In some cases, it is far too frequent; in others, it is not frequent enough. For older persons at low risk for skin breakdown, this practice ...
ver más ... 2018Don’t use restraints with older persons unless all other alternatives have been explored.
Choosing Wisely Canada
Canadian Nurses Association & Canadian Gerontological Nursing Association
Restraints are most often applied when an older person is distressed or has a change in medical status. These situations require immediate assessment and attention, not restraint. Restraints can be mechanical, physical, chemical or environmental in nature — for example, devices or medications that can be used to restrict a person’s movement. Perceived benefits of restraints are often outweighed by their significant potential for harm, including serious complications and even death. Safe, ...
ver más ... 2018