{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T15:24:57Z","timestamp":1777476297200,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Canadian Radiological Foundation (CRF) and Canadian Heads of Academic Radiology (CHAR) Research Grant"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can Assoc Radiol J"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    To develop Choosing Wisely Canada (CWC) recommendations for musculoskeletal (MSK) imaging indications, informed by the 2024 Canadian Association of Radiologists (CAR) Musculoskeletal System Diagnostic Imaging Referral Guideline.\n                    <jats:bold>Methods:<\/jats:bold>\n                    A Steering Committee comprising multidisciplinary MSK experts was convened to guide recommendation development. Using a two-round Delphi method, committee members selected the top 3 scenarios from the CAR MSK referral guidelines deemed most impactful for addressing overuse. Recommendations based on these scenarios were then drafted using the CWC format.\n                    <jats:bold>Results:<\/jats:bold>\n                    The 3 recommendations developed are: (1) Don\u2019t order MRI without first considering ultrasound for the assessment of rotator cuff pathology and bursitis; (2) Don\u2019t order MRI of the hip or knee when x-ray demonstrates greater than mild osteoarthritis, unless recommended by a musculoskeletal specialist; and (3) Don\u2019t order MRI of the hip just based on x-ray features of femoroacetabular impingement unless there are clinical signs and symptoms of joint impingement.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    This project represents a knowledge translation initiative to disseminate updated MSK imaging guideline recommendations. It strengthens the collaboration between CAR and CWC and establishes a reproducible structured consensus approach that can be applied to developing additional CWC imaging recommendations across the remaining 12 CAR referral guidelines in other subspecialties. This work supports value-based radiology, promoting optimized resource use.\n                  <\/jats:p>","DOI":"10.1177\/08465371251339389","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T02:41:26Z","timestamp":1748313686000},"page":"195-201","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing Musculoskeletal Imaging Referrals: Making Wise Choices a Knee-Jerk Reaction"],"prefix":"10.1177","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9672-6807","authenticated-orcid":false,"given":"Natalia","family":"Gorelik","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology, McGill University, Montreal, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7870-0969","authenticated-orcid":false,"given":"Courtney R.","family":"Green","sequence":"additional","affiliation":[{"name":"Canadian Association of Radiologists, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5871-2137","authenticated-orcid":false,"given":"Candyce","family":"Hamel","sequence":"additional","affiliation":[{"name":"Canadian Association of Radiologists, Ottawa, ON, Canada"},{"name":"School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7319-2285","authenticated-orcid":false,"given":"Anne-Marie","family":"LeBlanc","sequence":"additional","affiliation":[{"name":"Canadian Academy of Sport and Exercise Medicine, Ottawa, ON, Canada"},{"name":"River Valley Medical Clinic, Whitehorse, YT, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1829-6885","authenticated-orcid":false,"given":"Bheeshma","family":"Ravi","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle R.","family":"Frost","sequence":"additional","affiliation":[{"name":"Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, SK, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugue","family":"Ouellette","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4516-0481","authenticated-orcid":false,"given":"Kuan-chin Jean","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9869-6091","authenticated-orcid":false,"given":"Lisa Y.","family":"Liang","sequence":"additional","affiliation":[{"name":"South Oakville Medical Group, Oakville, ON, Canada"},{"name":"Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2774-9746","authenticated-orcid":false,"given":"Nitai","family":"Gelber","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-4208","authenticated-orcid":false,"given":"Reza","family":"Mirza","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1787-9096","authenticated-orcid":false,"given":"Kawan S.","family":"Rakhra","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Canadian Medical Imaging Inventory 2022\u20132023: The Medical Imaging Team: CMII Report. 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