Experts cite five orthopedic tests that physicians and patients should question

Pediatric orthopedic experts have agreed on a list of five tests and procedures that pediatric physicians and their patients should question.

The American Academy of Pediatrics–Section on Orthopaedics and the Pediatric Orthopaedic Society of North America (POSNA) provide the following list:

• Do not order a screening hip ultrasound to rule out developmental hip dysplasia or developmental hip dislocation if the baby has no risk factors and has a clinically stable hip examination.
• Do not order radiographs or advise bracing or surgery for a child less than 8 years of age with simple in-toeing gait.
• Do not order custom orthotics or shoe inserts for a child with minimally symptomatic or asymptomatic flat feet.
• Do not order advanced imaging studies (MRI or CT) for most musculoskeletal conditions in a child until all appropriate clinical, laboratory, and plain radiographic examinations have been completed.
• Do not order follow-up x-rays for buckle (or torus) fractures if they are no longer tender or painful.

This list was developed based on data collected from 2014-2015 from the POSNA Evidence Based Committee and Advocacy Committee. Approximately 20 members of the two committees participated in the process. They submitted five items each from their practices and experience of tests or procedures that they found were commonly overutilized. The items were placed in order of number of times listed by each surgeon; a total of 30 items were submitted. The two committees then agreed on a final list of five procedures, based on frequency of responses and importance of the condition. After the list was reviewed and feedback provided, the POSNA board of directors voted on a final list. The AAP Executive Committee then provided final approval.

The committee noted that the list is provided for informational purposes and is not intended as a substitute for consultation with a physician.

Read the full list with more details here.

[email protected]

Pediatric orthopedic experts have agreed on a list of five tests and procedures that pediatric physicians and their patients should question.

The American Academy of Pediatrics–Section on Orthopaedics and the Pediatric Orthopaedic Society of North America (POSNA) provide the following list:

• Do not order a screening hip ultrasound to rule out developmental hip dysplasia or developmental hip dislocation if the baby has no risk factors and has a clinically stable hip examination.
• Do not order radiographs or advise bracing or surgery for a child less than 8 years of age with simple in-toeing gait.
• Do not order custom orthotics or shoe inserts for a child with minimally symptomatic or asymptomatic flat feet.
• Do not order advanced imaging studies (MRI or CT) for most musculoskeletal conditions in a child until all appropriate clinical, laboratory, and plain radiographic examinations have been completed.
• Do not order follow-up x-rays for buckle (or torus) fractures if they are no longer tender or painful.

This list was developed based on data collected from 2014-2015 from the POSNA Evidence Based Committee and Advocacy Committee. Approximately 20 members of the two committees participated in the process. They submitted five items each from their practices and experience of tests or procedures that they found were commonly overutilized. The items were placed in order of number of times listed by each surgeon; a total of 30 items were submitted. The two committees then agreed on a final list of five procedures, based on frequency of responses and importance of the condition. After the list was reviewed and feedback provided, the POSNA board of directors voted on a final list. The AAP Executive Committee then provided final approval.

The committee noted that the list is provided for informational purposes and is not intended as a substitute for consultation with a physician.

Read the full list with more details here.

[email protected]

Pediatric orthopedic experts have agreed on a list of five tests and procedures that pediatric physicians and their patients should question.

The American Academy of Pediatrics–Section on Orthopaedics and the Pediatric Orthopaedic Society of North America (POSNA) provide the following list:

• Do not order a screening hip ultrasound to rule out developmental hip dysplasia or developmental hip dislocation if the baby has no risk factors and has a clinically stable hip examination.
• Do not order radiographs or advise bracing or surgery for a child less than 8 years of age with simple in-toeing gait.
• Do not order custom orthotics or shoe inserts for a child with minimally symptomatic or asymptomatic flat feet.
• Do not order advanced imaging studies (MRI or CT) for most musculoskeletal conditions in a child until all appropriate clinical, laboratory, and plain radiographic examinations have been completed.
• Do not order follow-up x-rays for buckle (or torus) fractures if they are no longer tender or painful.

This list was developed based on data collected from 2014-2015 from the POSNA Evidence Based Committee and Advocacy Committee. Approximately 20 members of the two committees participated in the process. They submitted five items each from their practices and experience of tests or procedures that they found were commonly overutilized. The items were placed in order of number of times listed by each surgeon; a total of 30 items were submitted. The two committees then agreed on a final list of five procedures, based on frequency of responses and importance of the condition. After the list was reviewed and feedback provided, the POSNA board of directors voted on a final list. The AAP Executive Committee then provided final approval.

The committee noted that the list is provided for informational purposes and is not intended as a substitute for consultation with a physician.

Read the full list with more details here.

[email protected]