Fibromuscular dysplasia diagnostic study of choice: Difference between revisions

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__NOTOC__
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{{Fibromuscular dysplasia}}
{{Fibromuscular dysplasia}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}}{{M.B}}
== Overview ==
== Overview ==
*Imaging modilities are the methods for diagnosing FMD.
Catheter-based [[angiography]] is the gold standard test for the diagnosis of renovascular fibromuscular dysplasia. Imaging modilities are the methods for diagnosing FMD. [[Duplex ultrasound|Duplex ultrasonography]], accompanied by [[CT angiography|computed tomographic angiography]] ([[CT angiography|CTA]]), and [[magnetic resonance angiography]] ([[Magnetic resonance angiography|MRA]]), are imaging techniques for detecting FMD lesions but the gold standard remains catheter-based [[Angiogram|angiography]].
*Duplex ultrasonography, accompanied by computed tomographic angiography (CTA), and magnetic
resonance angiography (MRA), are imaging techniques for detecting FMD lesions but the gold standard remains catheter-based angiography.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
=== Study of choice ===
=== Study of choice ===
* Catheter-based [[angiography]] is the gold standard test for the diagnosis of fibromuscular dysplasia.
* Catheter-based [[angiography]] is the gold standard test for the diagnosis of renovascular fibromuscular dysplasia.<ref>{{Cite journal
* The following result of Catheter-based angiography is confirmatory of fibromuscular dysplasia:
| author = [[Jeffrey W. Olin]], [[Heather L. Gornik]], [[J. Michael Bacharach]], [[Jose Biller]], [[Lawrence J. Fine]], [[Bruce H. Gray]], [[William A. Gray]], [[Rishi Gupta]], [[Naomi M. Hamburg]], [[Barry T. Katzen]], [[Robert A. Lookstein]], [[Alan B. Lumsden]], [[Jane W. Newburger]], [[Tatjana Rundek]], [[C. John Sperati]] & [[James C. Stanley]]
** Multifocal FMD. Imaging may reveal a beaded appearance to the affected artery string of beads
| title = Fibromuscular dysplasia: state of the science and critical unanswered questions: a scientific statement from the American Heart Association
** Focal FMD – Imaging may reveal a concentric, smooth, band-like focal stenosis or a tubular stenosis (image 2)
| journal = [[Circulation]]
**extreme arterial tortuosity. This is most common in the carotid, vertebral, and coronary arteries (image 3),
| volume = 129
| issue = 9
| pages = 1048–1078
| year = 2014
| month = March
| doi = 10.1161/01.cir.0000442577.96802.8c
| pmid = 24548843
}}</ref>


* The [name of the investigation] should be performed when:
** The patient presented with symptoms/signs 1. 2, 3.
** A positive [test] is detected in the patient.
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* The diagnostic study of choice for [disease name] is [name of the investigation].
* There is no single diagnostic study of choice for the diagnosis of [disease name].
* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
* [Disease name] is mainly diagnosed based on clinical presentation.
* Investigations:
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.


==== The comparison of various diagnostic studies for [disease name] ====
* The following result of Catheter-based angiography is confirmatory of fibromuscular dysplasia:
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
|}
<small> ✔= The best test based on the feature </small>
 
===== Diagnostic results =====
The following result of [investigation name] is confirmatory of [disease name]:
* Result 1
* Result 2
 
===== Sequence of Diagnostic Studies =====
The [name of investigation] should be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
 
=== Diagnostic Criteria ===
* Here you should describe the details of the diagnostic criteria.
*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:  
** Criteria 1
** Criteria 2
** Criteria 3


IF there are clear, established diagnostic criteria:
* Multifocal FMD: Imaging may reveal the classic string of beads appearance. (Image 1)[[File:FMD v2.jpg|500px|center]]
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
Focal FMD: Imaging may reveal a concentric, smooth, band-like focal [[stenosis]] or a [[tubular]] [[stenosis]] (image 2)[[File:Fibromuscular dysplasia.PNG|500px|center]]
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
* Extreme arterial tortuosity. This is most common in the [[Common carotid artery|carotid]], [[Vertebra|vertebral]], and [[coronary]] arteries.
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria: 
*There are no established criteria for the diagnosis of [disease name].


==References==
==References==

Latest revision as of 18:48, 30 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohsen Basiri M.D.

Overview

Catheter-based angiography is the gold standard test for the diagnosis of renovascular fibromuscular dysplasia. Imaging modilities are the methods for diagnosing FMD. Duplex ultrasonography, accompanied by computed tomographic angiography (CTA), and magnetic resonance angiography (MRA), are imaging techniques for detecting FMD lesions but the gold standard remains catheter-based angiography.

Diagnostic Study of Choice

Study of choice

  • Catheter-based angiography is the gold standard test for the diagnosis of renovascular fibromuscular dysplasia.[1]


  • The following result of Catheter-based angiography is confirmatory of fibromuscular dysplasia:
  • Multifocal FMD: Imaging may reveal the classic string of beads appearance. (Image 1)

Focal FMD: Imaging may reveal a concentric, smooth, band-like focal stenosis or a tubular stenosis (image 2)

References

  1. ↑ Jeffrey W. Olin, Heather L. Gornik, J. Michael Bacharach, Jose Biller, Lawrence J. Fine, Bruce H. Gray, William A. Gray, Rishi Gupta, Naomi M. Hamburg, Barry T. Katzen, Robert A. Lookstein, Alan B. Lumsden, Jane W. Newburger, Tatjana Rundek, C. John Sperati & James C. Stanley (2014). "Fibromuscular dysplasia: state of the science and critical unanswered questions: a scientific statement from the American Heart Association". Circulation. 129 (9): 1048–1078. doi:10.1161/01.cir.0000442577.96802.8c. PMID 24548843. Unknown parameter |month= ignored (help)

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