Choosing Wisely

Dr. Solow, Dr. Kazi, and Dr. Makris recently published the 2014 Update in Rheumatology in the Annals of Internal Medicine. In it, they highlight the Choosing Wisely Campaign and the Top 5 Tests Rheumatologists Should Question:

1. Do not test antinuclear antibody subserologies without a positive antinuclear antibody titer and clinical suspicion of immune-mediated disease (Grade 1C).

2. Do not test for Lyme disease as a cause of musculoskeletal symptoms without an exposure history and appropriate examination findings (Grade 1A).

3. Do not perform magnetic resonance imaging of the peripheral joints to routinely monitor inflammatory arthritis (Grade 1B).

4. Do not prescribe biologic agents for RA before a trial of methotrexate (or other conventional nonbiologic DMARD) (Grade 1A).

5. Do not routinely repeat dual-energy x-ray absorptiometry scans more often than once every 2 years (Grade 1C).

UTSW Internal Medicine

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