Table 1

The American College of Rheumatology's top 5 list for choosing wisely

1. Do not test anti-nuclear antibody (ANA) subserologies without a positive ANA and clinical suspicion of immune-mediated disease.

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

3. Do not perform magnetic resonance imaging of the peripheral joints to routinely monitor inflammatory arthritis.

4. Do not prescribe biologic agents for rheumatoid arthritis before a trial of methotrexate (or other conventional non-biologic disease-modifying anti-rheumatic drug).

5. Do not routinely repeat dual x-ray absorptiometry scans more often than once every 2 years.


Reproduced with permission from John Wiley & Sons [8].

Pisetsky Arthritis Research & Therapy 2013 15:117   doi:10.1186/ar4257