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Choosing Wisely Canada

Pediatric Sport & Exercise Medicine

Thoracic spine radiographs are not sufficient to evaluate scoliosis as they may not allow for adequate visualization of the curves, especially potential lumbar components. They also do not allow for assessment of the Risser index, a measure of the degree of iliac apophysis ossification and a marker for both skeletal maturity and potential curve progression. The Canadian Academy of Sport and Exercise Medicine (CASEM) Board approved the development of pediatric-specific sport and exercise ...

Choosing Wisely Canada

Pediatric Sport & Exercise Medicine

Scoliosis radiographic series consisting of full spine standing radiographs are not indicated in the evaluation of back pain unless there are clinical signs of scoliosis (asymmetry on Adams forward bend test, asymmetry of the shoulders, etc). When clinically indicated, radiographs are a good initial diagnostic tool to assess back pain but should be limited to the area of interest to limit radiation exposure.

Choosing Wisely Canada

Pediatric Sport & Exercise Medicine

Osgood Schlatter is a disease that consists of the detachment of the growth cartilage of the tibia as a consequence of making repeated gestures. It is manifested by the appearance of pain on the front side of the knee, below the kneecap and the appearance of a lump in the painful area. It is a clinical diagnosis based on an appropriate history and typical physical findings. Knee radiographs do not need to be performed if there is no acute concern (such as trauma, suspicion of an avulsion ...

Choosing Wisely®

American Society for Radiation Oncology

Cancer patients are at high risk for financial hardships due to lost productivity and uncovered treatment expenses. Radiation treatment decisions, including implemented technology, fractionation regimen, and whether radiation can be omitted, all may meaningfully influence the financial impact of the treatment on the patient. Heavy financial burdens can accrue, sometimes to the point of financial insolvency. Financial toxicity has been observed to be associated with reduced treatment compliance ...

Choosing Wisely Australia

Faculty of Pain Medicine, ANZCA

An individual's experience of pain in response to a noxious stimulus from surgery, trauma, or a general medical condition is variable and generally improves over time. Decisions about the management of acute pain should be tailored according to the individual assessment of the patient and the care setting. If the acute pain is moderate to severe and considered to be responsive to opioids, immediate-release opioids may be indicated as part of a multimodal analgesic regimen. Ideally, they should ...