Arnold-Chiari malformation diagnostic study of choice: Difference between revisions

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{{CMG}}; {{AE}} {{Fs}}
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== Overview ==
== Overview ==
[[MRI]] is the [[Gold standard (test)|gold standard]] test for the [[diagnosis]] of Arnold Chiari malformation. [[Cerebellar tonsill herniation|Cerebellar tonsillar herniation]], wedge shaped [[Cerebellar tonsil|tonsils]], syringohydromyelia, small [[posterior fossa]], obstructive [[hydrocephalus]], and [[Brain stem|brainstem]] anomalies.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==


=== Study of choice ===
=== Study of choice ===
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
[[MRI]] is the [[Gold standard (test)|gold standard]] test for the [[diagnosis]] of Arnold Chiari malformation.<ref name="MeadowsKraut2000">{{cite journal|last1=Meadows|first1=Jeffery|last2=Kraut|first2=Michael|last3=Guarnieri|first3=Michael|last4=Haroun|first4=Raymond I.|last5=Carson|first5=Benjamin S.|title=Asymptomatic Chiari Type I malformations identified on magnetic resonance imaging|journal=Journal of Neurosurgery|volume=92|issue=6|year=2000|pages=920–926|issn=0022-3085|doi=10.3171/jns.2000.92.6.0920}}</ref><ref name="PillayAwad1991">{{cite journal|last1=Pillay|first1=Prem K.|last2=Awad|first2=Issam A.|last3=Little|first3=John R.|last4=Hahn|first4=Joseph F.|title=Symptomatic Chiari Malformation in Adults: A New Classification Based on Magnetic Resonance Imaging with Clinical and Prognostic Significance|journal=Neurosurgery|volume=28|issue=5|year=1991|pages=639–645|issn=0148-396X|doi=10.1227/00006123-199105000-00001}}</ref>


OR
===== Diagnostic results =====
 
The following findings on performing [[MRI]] are confirmatory for Arnold Chiari malformation:
The following result of [gold standard test] is confirmatory of [disease name]:
* [Result 1]
* [Result 2]
 
OR
 
[Name of the investigation] must be performed when:
* The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
* A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
 
OR
 
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
 
OR
 
The diagnostic study of choice for [disease name] is [name of the investigation].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name].
 
OR
 
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].
 
OR
 
[Disease name] is primarily diagnosed based on the clinical presentation.
 
OR
 
Investigations:
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
* Among the 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] ====
*[[Cerebellar tonsill herniation|Cerebellar tonsillar herniation]]
{|
* Wedge shaped tonsils
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
* Syringohydromyelia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
* Small [[posterior fossa]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
* Obstructive [[hydrocephalus]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
* [[Brainstem]] anomalies
|-
! 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> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
 
===== Diagnostic results =====
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
* [Finding 1]
* [Finding 2]


===== Sequence of Diagnostic Studies =====
===== Sequence of Diagnostic Studies =====
The [name of investigation] must 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.
OR
The various investigations must be performed in the following order:
The various investigations must be performed in the following order:
* [Initial investigation]
*[[Physical examination|History and physical examination]]
* [2nd investigation]
*[[MRI]]
 
=== Name of Diagnostic Criteria ===
 
'''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.'''
 
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
 
OR
 
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
OR
 
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].
 
OR
 
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
* Criteria 1
* Criteria 2
* Criteria 3
 
OR
 
'''IF there are clear, established diagnostic criteria'''
 
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].
 
OR
 
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
'''IF there are no established diagnostic criteria'''


There are no established criteria for the diagnosis of [disease name].
===== Diagnostic criteria =====
There are no established criteria for the diagnosis of Arnold Chiari malformation.


==References==
==References==

Latest revision as of 21:00, 28 September 2019

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

Overview

MRI is the gold standard test for the diagnosis of Arnold Chiari malformation. Cerebellar tonsillar herniation, wedge shaped tonsils, syringohydromyelia, small posterior fossa, obstructive hydrocephalus, and brainstem anomalies.

Diagnostic Study of Choice

Study of choice

MRI is the gold standard test for the diagnosis of Arnold Chiari malformation.[1][2]

Diagnostic results

The following findings on performing MRI are confirmatory for Arnold Chiari malformation:

Sequence of Diagnostic Studies

The various investigations must be performed in the following order:

Diagnostic criteria

There are no established criteria for the diagnosis of Arnold Chiari malformation.

References

  1. ↑ Meadows, Jeffery; Kraut, Michael; Guarnieri, Michael; Haroun, Raymond I.; Carson, Benjamin S. (2000). "Asymptomatic Chiari Type I malformations identified on magnetic resonance imaging". Journal of Neurosurgery. 92 (6): 920–926. doi:10.3171/jns.2000.92.6.0920. ISSN 0022-3085.
  2. ↑ Pillay, Prem K.; Awad, Issam A.; Little, John R.; Hahn, Joseph F. (1991). "Symptomatic Chiari Malformation in Adults: A New Classification Based on Magnetic Resonance Imaging with Clinical and Prognostic Significance". Neurosurgery. 28 (5): 639–645. doi:10.1227/00006123-199105000-00001. ISSN 0148-396X.

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