Clinical Significance of Conventional Rib Series in Patients with Minor Thoracic Trauma

Hoffstetter, Patrick; Dornia, Christian; Wagner, M; Suwaidi, M. H. Al; Niessen, Christoph; Dendl, Lena Marie; Stroszczyński, C.; Schreyer, A. G.

doi:10.1055/s-0033-1356383

Cited by 10 publications

(6 citation statements)

References 11 publications

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“…Moreover, these authors found that, compared to standard PA radiographs, rib series negatively impacted patient care by prolonging report turnaround time [10]. Hoffstetter et al [11] retrospectively reviewed 609 patients that underwent rib series in the emergency department and found that while diagnosing a higher number of rib fractures as compared to PA radiographs alone, there was no statistically significant difference in the number of patients who received medical treatment. If rib series are to be performed, Park et al [12] showed that interpreting images with both conventional grayscale and inverted grayscale views may improve detection of rib fractures, although this study did not assess if the improved detection had an effect on outcomes.…”

Section: Discussion Of Procedures By Variant Variant 1: Suspected Ribmentioning

confidence: 99%

ACR Appropriateness Criteria® Rib Fractures

Imaging¹,

Henry

Donnelly

et al. 2019

Journal of the American College of Radiology

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Rib fractures are the most common thoracic injury after minor blunt trauma. Although rib fractures can produce significant morbidity, the diagnosis of injuries to underlying organs is arguably more important as these complications are likely to have the most significant clinical impact. Isolated rib fractures have a relatively low morbidity and mortality and treatment is generally conservative. As such, evaluation with standard chest radiographs is usually sufficient for the diagnosis of rib fractures, and further imaging is generally not appropriate as there is little data that undiagnosed isolated rib fractures after minor blunt trauma affect management or outcomes. Cardiopulmonary resuscitation frequently results in anterior rib fractures and chest radiographs are usually appropriate (and sufficient) as the initial imaging modality in these patients. In patients with suspected pathologic fractures, chest CT or Tc-99m bone scans are usually appropriate and complementary modalities to chest radiography based on the clinical scenario.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.Disclaimer: The ACR Committee on Appropriateness Criteria and its expert panels have developed criteria for determining appropriate imaging examinations for diagnosis and treatment of specified medical condition(s). These criteria are intended to guide radiologists, radiation oncologists, and referring physicians in making decisions regarding radiologic imaging and treatment. Generally, the complexity and severity of a patient's clinical condition should dictate the selection of appropriate imaging procedures or treatments. Only those examinations generally used for evaluation of the patient's condition are ranked. Other imaging studies necessary to evaluate other co-existent diseases or other medical consequences of this condition are not considered in this document. The availability of equipment or personnel may influence the selection of appropriate imaging procedures or treatments. Imaging techniques classified as investigational by the FDA have not been considered in developing these criteria; however, study of new equipment and applications should be encouraged. The ultimate decision regarding the appropriateness of any specific radiologic examination or treatment must be made by the referring physician and radiologist in light of all the circumstances presented in a...

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Section: Discussion Of Procedures By Variant Variant 1: Suspected Ribmentioning

confidence: 99%

ACR Appropriateness Criteria® Rib Fractures

Imaging¹,

Henry

Donnelly

et al. 2019

Journal of the American College of Radiology

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“…Konservatif tedavi kararı alınan nondeplase kosta fraktürü olan hastalarda daha sonra gelişebilecek atelektazi ve pnömoninin önlenebilmesi için iyi ağrı yönetimi ve dolayısıyla iyi akciğer ventilasyonu sağ-lanmalıdır. Deplase kosta fraktürü için konservatif ya da cerrahi kararı ise hâlâ tartışmalıdır (2,9) . Travma sonrası akciğer herniasyonu tedavisinde ise genellikle cerrahi tedavi önerilmektedir.…”

Section: Discussionunclassified

“…Toraks travmalarının %70'i motorlu araç kazaları sonrası, %10-17'si yüksekten düşme sonrası meydana gelmektedir (2) . Künt toraks travmalarında en sık (hastaların yaklaşık %50'sinde) yaralanan iskelet sistemi komponenti kostalar olmaktadır (3) .…”

Section: Introductionunclassified

Lung Herniation Associated with Rib Fracture in an 11-year-old child

Atıcı¹,

Eryazğan²

2017

tcdd

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“…Radiography focused on the ribs has been reported to be useful for the diagnosis of rib fractures. [3][4][5] It is easily performed, except in patients with severe pain. Cough-induced rib fractures often occur in the middle and lower ribs.…”

Section: Discussionmentioning

confidence: 99%