Trends in utilization

Has extremity MR imaging replaced diagnostic arthroscopy?

Nicole Glynn, William B. Morrison, Laurence Parker, Mark E. Schweitzer, John A. Carrino

Research output: Contribution to journalArticle

Abstract

Objective: To examine the relative change in utilization of magnetic resonance (MR) imaging of the extremities versus diagnostic and therapeutic arthroscopy. Design and patients: Using the 1993, 1996, and 1999 nationwide Medicare Part B databases, utilization rates (per 100,000) were determined for upper and lower extremity MR imaging, diagnostic arthroscopy and therapeutic arthroscopy using CPT-4 codes. Utilization of extremity MR imaging was compared with that of diagnostic and therapeutic arthroscopy in 10 geographic regions of the United States and tracked over time. Results: Combined lower and upper extremity MR imaging utilization per 100,000 increased from 393 to 1,056 in 1999 (+168.7%). Utilization of diagnostic arthroscopy of the extremities decreased from 18 in 1993 to 8 in 1999 (-55.6%); therapeutic arthroscopy rates increased from 461 in 1993 to 636 in 1999 (+40.0%). Specifically, from 1993 to 1999, utilization of lower extremity MR imaging increased from 270 to 661 (+144.8%). Utilization of diagnostic arthroscopy of the knee over the same time period decreased from 11 to 5 (-54.5%); therapeutic arthroscopy increased from 394 to 501 (+27.2%). Similarly, utilization rates for upper extremity MR imaging increased from 123 to 395 (+221.1%). Utilization of diagnostic arthroscopy of the shoulder over the same time period decreased from 7 to 2 (-71.4%); therapeutic arthroscopy increased from 44 to 104 (+136.4%). No specific geographic trends were ascertained. Conclusion: The utilization of MR imaging of the extremities has markedly increased from 1993 to 1999. During the same time period the utilization of diagnostic arthroscopy has decreased and that of therapeutic arthroscopy has increased. These findings support the hypothesis that there is increased reliance of clinical practitioners on the diagnostic information provided by MR imaging in preoperative clinical decision-making.

Original languageEnglish (US)
Pages (from-to)272-276
Number of pages5
JournalSkeletal Radiology
Volume33
Issue number5
DOIs
StatePublished - May 2004
Externally publishedYes

Fingerprint

Arthroscopy
Extremities
Magnetic Resonance Imaging
Lower Extremity
Therapeutics
Medicare Part B
Current Procedural Terminology
Upper Extremity
Knee
Databases

Keywords

  • Arthroscopy
  • Extremities, MR
  • Joints, MR
  • Joints, surgery
  • Magnetic resonance (MR), utilization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Glynn, N., Morrison, W. B., Parker, L., Schweitzer, M. E., & Carrino, J. A. (2004). Trends in utilization: Has extremity MR imaging replaced diagnostic arthroscopy? Skeletal Radiology, 33(5), 272-276. https://doi.org/10.1007/s00256-004-0750-5

Trends in utilization : Has extremity MR imaging replaced diagnostic arthroscopy? / Glynn, Nicole; Morrison, William B.; Parker, Laurence; Schweitzer, Mark E.; Carrino, John A.

In: Skeletal Radiology, Vol. 33, No. 5, 05.2004, p. 272-276.

Research output: Contribution to journalArticle

Glynn, N, Morrison, WB, Parker, L, Schweitzer, ME & Carrino, JA 2004, 'Trends in utilization: Has extremity MR imaging replaced diagnostic arthroscopy?', Skeletal Radiology, vol. 33, no. 5, pp. 272-276. https://doi.org/10.1007/s00256-004-0750-5
Glynn, Nicole ; Morrison, William B. ; Parker, Laurence ; Schweitzer, Mark E. ; Carrino, John A. / Trends in utilization : Has extremity MR imaging replaced diagnostic arthroscopy?. In: Skeletal Radiology. 2004 ; Vol. 33, No. 5. pp. 272-276.
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title = "Trends in utilization: Has extremity MR imaging replaced diagnostic arthroscopy?",
abstract = "Objective: To examine the relative change in utilization of magnetic resonance (MR) imaging of the extremities versus diagnostic and therapeutic arthroscopy. Design and patients: Using the 1993, 1996, and 1999 nationwide Medicare Part B databases, utilization rates (per 100,000) were determined for upper and lower extremity MR imaging, diagnostic arthroscopy and therapeutic arthroscopy using CPT-4 codes. Utilization of extremity MR imaging was compared with that of diagnostic and therapeutic arthroscopy in 10 geographic regions of the United States and tracked over time. Results: Combined lower and upper extremity MR imaging utilization per 100,000 increased from 393 to 1,056 in 1999 (+168.7{\%}). Utilization of diagnostic arthroscopy of the extremities decreased from 18 in 1993 to 8 in 1999 (-55.6{\%}); therapeutic arthroscopy rates increased from 461 in 1993 to 636 in 1999 (+40.0{\%}). Specifically, from 1993 to 1999, utilization of lower extremity MR imaging increased from 270 to 661 (+144.8{\%}). Utilization of diagnostic arthroscopy of the knee over the same time period decreased from 11 to 5 (-54.5{\%}); therapeutic arthroscopy increased from 394 to 501 (+27.2{\%}). Similarly, utilization rates for upper extremity MR imaging increased from 123 to 395 (+221.1{\%}). Utilization of diagnostic arthroscopy of the shoulder over the same time period decreased from 7 to 2 (-71.4{\%}); therapeutic arthroscopy increased from 44 to 104 (+136.4{\%}). No specific geographic trends were ascertained. Conclusion: The utilization of MR imaging of the extremities has markedly increased from 1993 to 1999. During the same time period the utilization of diagnostic arthroscopy has decreased and that of therapeutic arthroscopy has increased. These findings support the hypothesis that there is increased reliance of clinical practitioners on the diagnostic information provided by MR imaging in preoperative clinical decision-making.",
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