Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?

Trauma patients in a Level I Pediatric Trauma Center may undergo CT of the abdomen and pelvis with concurrent radiograph during initial evaluation in an attempt to diagnose injury. To determine if plain digital radiograph of the pelvis adds additional information in the initial trauma evaluation whe...

Full description

Saved in:
Bibliographic Details
Main Authors: Anne K. Misiura, Autumn D. Nanassy, Jacqueline Urbine
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:International Journal of Pediatrics
Online Access:http://dx.doi.org/10.1155/2018/6260954
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849695515848998912
author Anne K. Misiura
Autumn D. Nanassy
Jacqueline Urbine
author_facet Anne K. Misiura
Autumn D. Nanassy
Jacqueline Urbine
author_sort Anne K. Misiura
collection DOAJ
description Trauma patients in a Level I Pediatric Trauma Center may undergo CT of the abdomen and pelvis with concurrent radiograph during initial evaluation in an attempt to diagnose injury. To determine if plain digital radiograph of the pelvis adds additional information in the initial trauma evaluation when CT of the abdomen and pelvis is also performed, trauma patients who presented to an urban Level I Pediatric Trauma Center between 1 January 2010 and 7 February 2017 in whom pelvic radiograph and CT of the abdomen and pelvis were performed within 24 hours of each other were analyzed. A total of 172 trauma patients had pelvic radiograph and CT exams performed within 24 hours of each other. There were 12 cases in which the radiograph missed pelvic fractures seen on CT and 2 cases in which the radiograph suspected a fracture that was not present on subsequent CT. Furthermore, fractures in the pelvis were missed on pelvic radiographs in 12 of 35 cases identified on CT. Sensitivity of pelvic radiograph in detecting fractures seen on CT was 65.7% with a 95% confidence interval of 47.79-80.87%. Results suggest that there is no added diagnostic information gained from a pelvic radiograph when concurrent CT is also obtained, a practice which exposes the pediatric trauma patient to unnecessary radiation.
format Article
id doaj-art-cfc101a734bf4a4caf2416b07ef26f33
institution DOAJ
issn 1687-9740
1687-9759
language English
publishDate 2018-01-01
publisher Wiley
record_format Article
series International Journal of Pediatrics
spelling doaj-art-cfc101a734bf4a4caf2416b07ef26f332025-08-20T03:19:46ZengWileyInternational Journal of Pediatrics1687-97401687-97592018-01-01201810.1155/2018/62609546260954Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?Anne K. Misiura0Autumn D. Nanassy1Jacqueline Urbine2Hahnemann University Hospital, 230 North Broad Street, Philadelphia, PA 19102, USASt. Christopher’s Hospital for Children, 160 East Erie Avenue, Philadelphia, PA 19134, USASt. Christopher’s Hospital for Children, 160 East Erie Avenue, Philadelphia, PA 19134, USATrauma patients in a Level I Pediatric Trauma Center may undergo CT of the abdomen and pelvis with concurrent radiograph during initial evaluation in an attempt to diagnose injury. To determine if plain digital radiograph of the pelvis adds additional information in the initial trauma evaluation when CT of the abdomen and pelvis is also performed, trauma patients who presented to an urban Level I Pediatric Trauma Center between 1 January 2010 and 7 February 2017 in whom pelvic radiograph and CT of the abdomen and pelvis were performed within 24 hours of each other were analyzed. A total of 172 trauma patients had pelvic radiograph and CT exams performed within 24 hours of each other. There were 12 cases in which the radiograph missed pelvic fractures seen on CT and 2 cases in which the radiograph suspected a fracture that was not present on subsequent CT. Furthermore, fractures in the pelvis were missed on pelvic radiographs in 12 of 35 cases identified on CT. Sensitivity of pelvic radiograph in detecting fractures seen on CT was 65.7% with a 95% confidence interval of 47.79-80.87%. Results suggest that there is no added diagnostic information gained from a pelvic radiograph when concurrent CT is also obtained, a practice which exposes the pediatric trauma patient to unnecessary radiation.http://dx.doi.org/10.1155/2018/6260954
spellingShingle Anne K. Misiura
Autumn D. Nanassy
Jacqueline Urbine
Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?
International Journal of Pediatrics
title Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?
title_full Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?
title_fullStr Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?
title_full_unstemmed Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?
title_short Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?
title_sort usefulness of pelvic radiographs in the initial trauma evaluation with concurrent ct is additional radiation exposure necessary
url http://dx.doi.org/10.1155/2018/6260954
work_keys_str_mv AT annekmisiura usefulnessofpelvicradiographsintheinitialtraumaevaluationwithconcurrentctisadditionalradiationexposurenecessary
AT autumndnanassy usefulnessofpelvicradiographsintheinitialtraumaevaluationwithconcurrentctisadditionalradiationexposurenecessary
AT jacquelineurbine usefulnessofpelvicradiographsintheinitialtraumaevaluationwithconcurrentctisadditionalradiationexposurenecessary