Abstract：
BACKGROUND:More than 100 MRIs per 1000 inhabitants are performed in the United States annually, more than almost every other country. Little is known regarding the cost of obtaining an MRI and factors associated with differences in cost. QUESTIONS/PURPOSES:By surveying all hospital-owned and independent imaging centers in Iowa, we wished to determine (1) the cost to the consumer of obtaining a noncontrast shoulder MRI, (2) the frequency and magnitude of discounts provided, and (3) factors associated with differences in cost including location (hospital-owned or independent) and Centers for Medicare & Medicaid Services designation (rural, urban, and critical access). METHODS:There were 71 hospitals and 26 independent imaging centers that offered MRI services in Iowa. Each site was contacted via telephone and posed a scripted request for the cost of the technical component of a noncontrast shoulder MRI. Radiologists' reading fees were not considered. Statistical analysis was performed using standard methods and significance was defined as a probability less than 0.05. RESULTS:The mean technical component cost to consumers for an MRI was USD 1874 ± USD 694 (range, USD 500-USD 4000). Discounts were offered by 49% of imaging centers, with a mean savings of 21%. Factors associated with increased cost include hospital-owned imaging centers (USD 2062 ± USD 664 versus USD 1400 ± USD 441 at independent imaging centers; p < 0.001; mean difference, USD 662; 95% CI, USD 351-USD 893) and rural imaging centers, unless designated as a critical access hospital (USD 2213 ± USD 668 versus USD 1794 ± USD 680; p = 0.0202; mean difference, USD 419; 95% CI, USD 66-USD 772). CONCLUSIONS:In Iowa, the cost to the consumer of a shoulder MRI is significantly less at independent imaging centers compared with hospital-owned centers. Referring physicians and healthcare consumers should be aware that there may be substantial price discrepancies between centers that provide advanced imaging services. LEVEL OF EVIDENCE:Level IV, Economic and decision analysis.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Westermann RW,Schick C,Graves CM,Duchman KR,Weinstein SLdoi
10.1007/s11999-016-5181-9subject
Has Abstractpub_date
2017-03-01 00:00:00pages
580-584issue
3eissn
0009-921Xissn
1528-1132pii
10.1007/s11999-016-5181-9journal_volume
475pub_type
杂志文章abstract：:Tuberculosis was first described in 1756 by Acrel in a case report. Subsequent reports of musculoskeletal tuberculosis documented the uncommon occurrence of hand and wrist involvement. The two cases presented here demonstrate the difficulty in eradicating the organism even with modern regimens of chemotherapy. Intraop...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：BACKGROUND:Surgeons perform THA to address a variety of conditions in younger patients, including osteoarthritis (OA), osteonecrosis, inflammatory arthritis, and congenital deformities. Younger patients aged 50 years or younger have been characterized as active in the literature, but a direct relationship between age a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3952-8
更新日期：2015-03-01 00:00:00
abstract：:One hundred fifteen patients with nonunions or delayed fracture healing were treated with high-energy shock waves. After shock wave treatment, immobilization of the fracture also was done. The followup was at least 3 months and as long as 4 years. In 87 patients (75.7%), one treatment with shock waves resulted in bony...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200106000-00012
更新日期：2001-06-01 00:00:00
abstract：:Osteoarthropathy in congenital sensory neuropathy with anhidrosis (CSNA) is not only a rare complication but also difficult to treat. Two patients with CSNA, a three-year-old boy and a 24-year-old woman, were treated as follows. The boy was affected in his left knee and left heel and required reduction of recurrent bi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:For a mean period of 7.8 years, the morphology of knee deformity and its annual changes in 8 patients (16 knees; mean age at the initial examination, 8.4 years) with multiple hereditary exostoses were evaluated radiographically. Knee deformity developed during the growth spurt period. Genu valgum with a femorotibial a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-04-01 00:00:00
abstract：:It is well-known that the long-standing relationship between orthopaedics and industry has benefited both parties. However, strong evidence indicates that the relationship is no longer a balanced one. Through a very effective stratagem, industry has used its enormous marketing power to a degree where the education of ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000074407.99625.67
更新日期：2003-07-01 00:00:00
abstract：:Tibial articular cartilage and the knee meniscus from cast-immobilized rabbits whose quadriceps were electrically stimulated for 17 days were compared with those from cast-immobilized rabbits without muscle stimulation. Cartilage from non-stimulated rabbits showed evidence of deep fibrillation and loss of Safranin O m...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：BACKGROUND:Minimally invasive surgery (MIS) approaches have the potential to reduce procedure-related morbidity when compared with traditional approaches. However, the magnitude of radiographic correction and degree of clinical improvement with MIS techniques for adult spinal deformity remain undefined. QUESTION/PURPO...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-013-3441-5
更新日期：2014-06-01 00:00:00
abstract：:Three typical cases demonstrate the achievement of precision in the reconstruction of ununited fractures of the tibia by preliminary planning with the aid of tracings on roentgenograms, templates, and goniometer measurements. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-09-01 00:00:00
abstract：BACKGROUND:For unicompartmental knee arthroplasty (UKA), abnormal loading on the tibiofemoral joint could exacerbate knee osteoarthritis or implant wear. Joint moments are an indirect measure of such loading. However, little is known about knee moments of patients with UKA, tempering enthusiasm for its use. QUESTIONS/...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3128-y
更新日期：2014-01-01 00:00:00
abstract：UNLABELLED:Although acute management of pelvic fractures and their long-term functional outcome have been widely documented, important information regarding malunion and nonunion of these fractures is sparse. Despite their relative rarity, malunions and nonunions cause disabling symptoms and have major socioeconomic im...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-009-0712-2
更新日期：2009-08-01 00:00:00
abstract：:Longstanding untreated congenital torticollis in adults is uncommon and surgical release in such a case can be hazardous or fraught with many possible complications. A two-stage, open, bipolar surgical division of the contracted sternocleidomastoid muscle in a 33-year-old woman who developed pain and paresthesiae in t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-03-01 00:00:00
abstract：:Osteopetrosis is a metabolic bone disease characterized by a systemic increase in skeletal mass. It results from a defect in the production or function of osteoclasts and is inherited in nine genetically distinct osteopetrotic animal mutations and man. Studies of these mutations have revealed that osteopetrosis is a c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1993-09-01 00:00:00
abstract：:This biographical sketch on John Caffey corresponds to the historic text, The Classic: Multiple Fractures in the Long Bones of Infants Suffering From Chronic Subdural Hematoma (1946), available at DOI 10.1007/s11999-010-1666-0 . ...
journal_title：Clinical orthopaedics and related research
pub_type： 传,历史文章
doi：10.1007/s11999-010-1665-1
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:Metal-on-metal hip resurfacing arthroplasty (MOM HR) has become an established alternative to traditional metal-on-metal total hip arthroplasty (MOM THA) for younger, more active patients. Nevertheless, concerns remain regarding wear and corrosion of the bearing surfaces and the resulting systemic metal ion ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2981-z
更新日期：2013-09-01 00:00:00
abstract：:Rotator cuff repair is one of the most common surgical procedures done in the shoulder. Traditionally, repair has required an open incision with release of a portion of the deltoid from the acromion. In the past decade, an arthroscopically-assisted, mini-open approach has gained popularity. This has been facilitated b...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：2001-09-01 00:00:00
abstract：:The spike procedure is applicable as a substitute for a fixation device. In open tubular bone fractures, the spike procedure utilizes the open fracture bone ends to create an intrinsically stable situation in place of pins or extrinsic devices. One end of the tubular bone fracture is fitted into the medullary canal of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-05-01 00:00:00
abstract：:This study determined whether patients with severe knee disease below a hip arthrodesis can be treated successfully with total knee replacement alone or whether such patients require total hip arthroplasty followed by knee replacement. Eighteen patients who had hip arthrodesis for a mean of 33 years underwent total hi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200002000-00017
更新日期：2000-02-01 00:00:00
abstract：:The literature documents progression of spondylolisthesis, most commonly during the adolescent growth spurt. Twenty-eight patients with Grades I and II spondylolisthesis were treated with antilordotic braces. Presenting signs and symptoms included back pain (61%), tight hamstrings (53%), increased lordosis (25%), and ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-11-01 00:00:00
abstract：:Of 84 fracture dislocations of the hip reviewed, 73 were posterior fracture dislocations, nine were central, and two were obturator. Fifty-five were followed from one to 30 years (average, 4 1/2 years). The patients' ages ranged from three to 83 years (average, 33.1 years). All had primary attempt at closed reduction,...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：BACKGROUND:There are a variety of postoperative immobilization and therapy options for patients with basal joint arthritis. Although prior systematic reviews have compared surgical procedures used to treat basal joint arthritis, none to our knowledge compares therapy protocols for this condition, which are considered a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-013-3285-z
更新日期：2014-04-01 00:00:00
abstract：:In this study, the authors investigated enhancing the results of autoclaved autograft bone by combining it with a vascularized bone graft and supplementing it with autogenous bone marrow for replacement of a 2-cm tibial defect in the rabbit model. The study was divided into 4 groups. Group I consisted of autoclaved au...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：:Popliteal artery injury during surgery of the knee is rare but can have devastating consequences. The position of knee flexion has been thought to be protective for the popliteal artery, allowing it to fall back from the knee joint. No prior study has provided in vivo cross sectional evidence of the behavior of the po...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-10-01 00:00:00
abstract：:For patients with advanced cancer who present with or develop a bone lesion as the only focus of cancer beyond the primary site, en bloc resection of the metastasis may optimize local tumor control, provide durable pain relief, and possibly prolong patient survival. For patients with pelvic metastasis, however, this s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e3180619533
更新日期：2007-06-01 00:00:00
abstract：BACKGROUND:Numerous cementless femoral stem design variations are in clinical use. Because initial implant instability and micromotion are associated with aseptic loosening of the femoral component, migration analysis provides an early assessment of implant survivorship. QUESTIONS/PURPOSES:We determined the (1) migrat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2160-z
更新日期：2012-02-01 00:00:00
abstract：:To assess the impact of traumatic hip dislocations in the skeletally immature patient, 42 children younger than 16 years of age (average age, 9 years 10 months) who were treated at the authors' institution were studied. Data were collected from charts and radiographs and by completion of questionnaires. The average fo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2000-07-01 00:00:00
abstract：:Fixed flexion contracture can present a technical challenge in total knee arthroplasty. Various techniques of addressing these deformities have been described including additional bony resection, ligamentous releases, and the use of increasing constraint. We retrospectively reviewed the clinical outcomes of 40 patient...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000238801.90090.59
更新日期：2006-11-01 00:00:00
abstract：:The osteopenia associated with advanced age appears to be a universal phenomenon in humans and animals, but the mechanisms by which it occurs are understood incompletely. However, the explanation must lie in an absolute or relative diminution in the level of osteoblastic bone-forming activity when compared with osteoc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-04-01 00:00:00
abstract：BACKGROUND:Failure of THA or TKA to meet a patient's expectations may result in patient disappointment and litigation. However, there is little evidence to suggest that surgeons can consistently anticipate which patients will benefit from those interventions. QUESTIONS/PURPOSES:To determine the ability of surgeons to ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-017-5331-8
更新日期：2017-09-01 00:00:00
abstract：:After reviewing a series of 220 patients operated upon between 1975 and 1985 for traumatic brachial plexus injuries, the authors present the results of 103 myelographies, 48 computed tomographies (CT scans) combined with standard myelography, and 25 series of images obtained by magnetic resonance imaging (MRI). To eva...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-12-01 00:00:00
