Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Academy of Orthopaedic Surgeons and Pediatric Orthopaedic Society.

Use of Imaging Prior To Referral Of Musculoskeletal Specialist

American Academy of Orthopaedic Surgeons

Pediatric Orthopaedic Society

Publication Date: Feb 1, 2018

Page Last Updated: May 6, 2026

Interpreting the Strength of Evidence

Strength of Recommendation
Strength	Overall Strength of Evidence	Description of Evidence Quality
Strong	Strong	Evidence from two or more “High” quality studies with consistent findings for recommending for or against the intervention.
Moderate	Moderate	Evidence from two or more “Moderate” quality studies with consistent findings, or evidence from a single “High” quality study for recommending for or against the intervention.
Limited	Low Strength Evidence or Conflicting Evidence	Evidence from two or more “Low” quality studies with consistent findings or evidence from a single “Moderate” quality study recommending for against the intervention or diagnostic or the evidence is insufficient or conflicting and does not allow a recommendation for or against the intervention.
Consensus*	No Evidence	There is no supporting evidence. In the absence of reliable evidence, the guideline development group is making a recommendation based on their clinical opinion. Consensus statements are published in a separate, complimentary document.

Document Overview

Document Title: Use of Imaging Prior Referral To A Musculoskeletal Oncologist

Authoring Societies

American Academy of Orthopaedic Surgeons

Pediatric Orthopaedic Society

Document Publication Date: Feb 1, 2018

Page Last Reviewed/Updated: May 6, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.aaos.org/globalassets/quality-and-practice-resources/external-quality-products/msts-guideline-3.19.18_final-with-aaos-logo-9.17.18.pdf

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Scope: Assessment and Screening, Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D010016 - Osteoma

D018204 - Neoplasms, Connective and Soft Tissue

D012509 - Sarcoma

D010016 - Osteoma

D018204 - Neoplasms, Connective and Soft Tissue

D012509 - Sarcoma

Keywords: bone tumor, musculoskeletal oncology, osteoid osteoma, sarcoma, soft tissue neoplasm, soft tissue tumor

Inclusion Criteria: Adolescent, Adult, Child, Older Adult

Health Care Settings: Ambulatory, Emergency Care, Hospital, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physical Therapist, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Systematic Review Document

Number of Source Documents: 159

Literature Search Start Date: Wednesday, April 6, 2016

Literature Search End Date: Thursday, February 2, 2017

Includes peer/external review process?: Yes

Includes public comment process?: Yes

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Use of Imaging Prior To Referral Of Musculoskeletal Specialist

Recommendations

PLAIN RADIOGRAPHS

MRI: USE OF CONTRAST

MRI: MAGNET STRENGTH

MRI AND CT SCANS: AREA TO VISUALIZE

CT SCANS: STAGING

CT SCANS: PRIOR CHEST RADIOGRAPH

ULTRASOUND

HISTORY OF PAIN

HISTORY OF GROWTH

TUMOR SIZE

CORTICAL IRREGULARITY/PERIOSTEAL REACTION

TUMOR INTERFACE

Interpreting the Strength of Evidence

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology