Conservative Management Defined for imaging purposes Glossary of Medical Terms – Care to Care's Clinical Criteria

For many clinical situations a therapeutic trial (conservative management) is indicated before diagnostic imaging is approrpiate. In some cases this is a matter of cost efficiency, in others it may relate to the prevalence of false positive imaging results, which may lead to unnecessary further interventions when a simple course of medication and behavioral changes would have sufficed.

Important Notes

Medical or Conservative Management prior to imaging requirement is satisfied if the following are met:

1. Nonsteroidal anti-inflammatory drugs for at least three weeks (Requirement is waived if NSAIDS are not tolerated or contraindicated, or if condition worsens while under treatment.)

2. Activity modification or physical therapy if appropriate

Red Flags Disregard any requirement for prior management if any of the following are part of the clinical history:

Abnormal CBC, Sed Rate, etc.

Bladder and Bowel dysfunction

Fever

Cancer, History of Immunocompromised state

IV drug use

Major weakness of a limb

Pain increased at rest

Saddle anesthesia

Severe pain, not repsonding to opiates after two days

Trauma

Unexplained weight loss

Urinary tract infections

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