Journal of the American College of Radiology
Volume 6, Issue 10 , Pages 675-680, October 2009

ACR Appropriateness Criteria® on Acute Respiratory Illness

  • Lacey Washington, MD

      Affiliations

    • Duke University Medical Center, Durham, North Carolina
    • Corresponding Author InformationCorresponding author and reprints: Lacey Washington, MD, Duke University Medical Center, PO Box 3808, Durham, NC 27702-3808
    • ,
  • Arfa Khan, MD

      Affiliations

    • Long Island Jewish Medical Center, New Hyde Park, New York
    • ,
  • Tan-Lucien Mohammed, MD

      Affiliations

    • Cleveland Clinic Foundation, Cleveland, Ohio
    • ,
  • Poonam V. Batra, MD

      Affiliations

    • David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
    • ,
  • Jud W. Gurney, MD

      Affiliations

    • University of Nebraska, Omaha, Nebraska
    • ,
  • Linda B. Haramati, MD

      Affiliations

    • Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
    • ,
  • Jean Jeudy, MD

      Affiliations

    • University of Maryland Medical Center, Baltimore, Maryland
    • ,
  • Heber MacMahon, MD

      Affiliations

    • University of Chicago Hospital, Chicago, Illinois
    • ,
  • Anna Rozenshtein, MD

      Affiliations

    • Columbia Presbyterian Medical Center, New York, New York
    • ,
  • Kay H. Vydareny, MD

      Affiliations

    • Emory University Hospital, Atlanta, Georgia
    • ,
  • Larry Kaiser, MD

      Affiliations

    • University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
    • Society of Thoracic Surgeons, Chicago, Illinois
    • ,
  • Suhail Raoof, MBBS

      Affiliations

    • New York Methodist Hospital, Brooklyn, New York
    • American College of Chest Physicians, Northbrook, Illinois

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.

Key Words: Appropriateness criteria, pneumonia, diagnostic imaging

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 The ACR seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria® through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply society endorsement of the final document.

PII: S1546-1440(09)00318-4

doi:10.1016/j.jacr.2009.06.022

Journal of the American College of Radiology
Volume 6, Issue 10 , Pages 675-680, October 2009

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