ACR Appropriateness Criteria® on Acute Respiratory Illness

• Type of Material: Article
• Authors: Lacey Washington, Duke University Medical Center; Arfa Khan, Long Island Jewish Medical Center; Tan-Lucien Mohammed, Cleveland Clinic Foundation; Poonam V. Batra, David Geffen School of Medicine; Jud W. Gurney, University of Nebraska Omaha; Linda B. Haramati, Yeshiva University; Jean Jeudy, University of Maryland; Heber MacMahon, University of Chicago; Anna Rozenshtein, Columbia University; Kay Vydareny, Emory University; Larry Kaiser, University of Pennsylvania; Suhail Raoof, New York Methodist Hospital
• Language: English
• Date: 2009-01-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2009 American College of Radiology.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jacr.2009.06.022
• Title of Journal or Parent Work: Journal of the American College of Radiology
• Volume: 6
• Issue: 10
• Start Page: 675
• End Page: 680
• Keywords: United States; Societies, Medical; Humans; Tomography, X-Ray Computed; Practice Guidelines as Topic; Respiratory Distress Syndrome; Radiology
• Research Categories: Health Sciences, Radiology; Health Sciences, Health Care Management

Abstract

In a patient with acute respiratory illness (cough, sputum production, chest pain, and/or dyspnea), the need for chest imaging depends on the severity of illness, age of the patient, clinical history, physical and laboratory findings, and other risk factors. Chest radiographs seem warranted when one or more of the following are present: age ≥ 40; dementia; a positive physical examination; hemoptysis; associated abnormalities (leukocytosis, hypoxemia); or other risk factors, including coronary artery disease, congestive heart failure, or drug-induced acute respiratory failure. Chest CT may be warranted in complicated cases of severe pneumonia and in febrile neutropenic patients with normal or nonspecific chest radiographic findings. Literature on the indications and usefulness of radiologic studies for acute respiratory illness in different clinical settings is reviewed.