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Choosing Wisely UK

Chartered Society of Physiotherapy

Osteoarthritis is a disease that affects the joints. It is the most common type of arthritis and is seen more frequently in older people. Osteoarthritis causes pain, stiffness, and problems moving the joint. It usually affects the hips, knees, hands, and feet, but it can affect other joints. It can also affect more than one joint. It is diagnosed clinically and imaging tests are not usually necessary to confirm the diagnosis. The basic treatments are therapeutic exercise and weight control ...

NICE

NICE

Exceptional medical circumstances include the occurrence of serious side effects (for example, upper gastrointestinal bleeding from an antidepressant, respiratory depression from an opioid or severe ataxia from a gabapentinoid). In these circumstances, consider: -scheduling more frequent reviews -short-term use of medicines to treat the physical symptoms of withdrawal (for example, abdominal cramps and diarrhoea during withdrawal of an opioid). Medicines associated with dependence include ...

Choosing Wisely Canada

Pediatric Sport & Exercise Medicine

Complex regional pain syndrome is a chronic severe pain condition that involves peripheral, central and autonomic nervous system and immune system mechanisms. Immobilization of the painful area can lead to prolonged symptoms and poor outcomes and should be avoided unless required for underlying pathology. The Canadian Academy of Sport and Exercise Medicine (CASEM) Board approved the development of pediatric-specific sport and exercise medicine (SEM) Choosing Wisely Canada’s recommendations. ...

Choosing Wisely Canada

Canadian Society of Otolaryngology - Head & Neck Surgery 

Plain films have poor sensitivity and specificity and they cannot be relied upon to confirm or reject the diagnosis of either acute or chronic sinusitis. Air-fluid levels and complete sinus opacification are not reliably present in rhinosinusitis, and cannot differentiate between viral and bacterial etiologies. The findings of a sinus x-ray cannot be relied upon to diagnose rhinosinusitis, guide antibiotic prescribing, or plan surgery, they do not provide value in patient care and should be ...

Choosing Wisely Canada

Canadian Society of Otolaryngology - Head & Neck Surgery 

Acute bacterial rhinosinusitis (ABRS) does not require proof of a culture-identified pathogen. When patients meet criteria for uncomplicated ABRS, empiric antibiotic selection should be based on typical causative pathogens, local bacterial resistance patterns, and patient factors. Nasal swabs are contaminated by normal nasal flora and results correlate poorly with causative pathogens in rhinosinusitis. In situations where cultures are required, such as intraorbital or intracranial ...