Evaluation of the Role of Comparison Radiographs in the Diagnosis of Traumatic Elbow Injuries

Kissoon, Niranjan; Galpin, Robert; Gayle, Michael O.; Chacon, Daniella; Brown, Tamara L.

doi:10.1097/01241398-199507000-00007

Cited by 44 publications

(17 citation statements)

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“…Although the use of comparison views has been studied in the pediatric ED setting, 5,6 this is the first study to explore the current practices of EPs who do not work primarily in a pediatric ED. The results from this survey demonstrate that the vast majority of non-pediatric EPs selectively order comparison views for elbow injuries.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 As a result, comparison views of the uninjured arm have traditionally been recommended for all elbow injuries 4 to provide the clinician with an anatomically "normal" radiograph. However, studies by Chacon and coworkers 5 and Kissoon and colleagues 6 have demonstrated that among pediatric specialists (pediatric emergency medicine, orthopedics, radiology) there is no diagnostic utility for the routine use of comparison views. Use of comparison views by non-pediatric emergency physicians (EPs) has not been assessed.…”

Section: Introductionmentioning

confidence: 99%

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Comparison views to diagnose elbow injuries in children: a survey of Canadian non-pediatric emergency physicians

Dowling

Farion

Clifford

2005

CJEM

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Objectives: Elbow injuries in children are a common presenting complaint to the emergency department. Although radiography is a valuable tool in the diagnosis of this injury, x-rays of the injured elbow are inherently difficult to interpret. As a result, comparison views of the uninjured arm have traditionally been recommended to provide an anatomically "normal" radiograph. Recent studies have questioned the use of comparison views in the pediatric emergency department. The primary objective of this study was to determine current practices of non-pediatric emergency physicians in the use of comparison views for the diagnosis of elbow injuries in children. Methods: A self-administered mail survey was sent to 300 randomly selected emergency physicians, using the Canadian Association of Emergency Physicians database. Results: Two hundred and forty-two (81%) responses were received; 26 were excluded based on pre-determined criteria. Of eligible respondents, 95% ordered comparison views selectively and 64% of these physicians ordered comparison views infrequently. Eighty-eight percent found the comparison views to be "rarely" to "sometimes" useful. Forty-seven percent of respondents stated that they were only "somewhat" confident when interpreting x-rays of a child's elbow. Conclusion: This survey demonstrates that non-pediatric emergency physicians are using comparison views selectively for elbow injuries in children, despite being only "somewhat" confident in interpreting the x-rays. RÉSUMÉ Objectifs :Les blessures au coude chez les enfants sont une raison de consultation courante au dé-partement d'urgence. Bien que la radiographie soit un outil précieux dans le diagnostic de cette blessure, les clichés du coude blessé sont en soi difficiles à interpréter. Par conséquent, on recommande couramment le recours aux clichés de comparaison du bras non blessé pour offrir une radiographie anatomiquement «normale». Des études récentes ont remis en cause le recours aux clichés de comparaison au département d'urgence pédiatrique. L'objectif principal de la présente étude était de déterminer les pratiques actuelles des médecins d'urgence non pédiatriques quant au recours aux clichés de comparaison pour le diagnostic des blessures au coude chez les enfants. Méthodes : Un sondage auto-administré fut envoyé par la poste à 300 médecins d'urgence choisis

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison views to diagnose elbow injuries in children: a survey of Canadian non-pediatric emergency physicians

Dowling

Farion

Clifford

2005

CJEM

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“…Wy ma ga ją one wni kli wej oce ny przed pod ję ciem de cy zji o naj bar dziej od po wied nim spo so bie le czenia. Na dal cza sa mi obar czo ne są ry zy kiem wy stę powa nia po wi kłań [12,13].…”

Section: Wstępunclassified

“…All proximal radial fractures are complicated injuries of the skeletal system of the young patient. They require detailed assessment before deciding on the most adequate treatment method and still are sometimes prone to complications [12,13].…”

Section: Introductionmentioning

confidence: 99%

Operative treatment of radial neck fractures in children

Matuszewski

Kałakucki²,

Ciszewski³

2012

Ortopedia, traumatologia, rehabilitacja

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STRESZCZENIEWstęp. Ura zy oko li cy sta wu łok cio we go na le żą do czę stych uszko dzeń na rzą du ru chu u dzie ci. Spo śród nich zła ma nia bli ższe go od cin ka ko ści pro mie nio wej cha rak te ry zu je ró żno rod ność za sto so wa nych me tod le cze nia oraz ist nie ją ce ry zy ko po wi kłań.Cel pra cy. Pre zen ta cja ro dza jów i wy ni ków le cze nia zła mań bli ższe go od cin ka ko ści pro mie nio wej u dzie ci. Ma te riał i me to dy. Ba da nia opar te są na da nych uzy ska nych z hi sto rii cho rób 28 pa cjen tów le czo nych w latach 2006-2010. Ana li za ma te ria łu kli nicz ne go obej mo wa ła sto pień prze miesz cze nia odła mu, wiek, płeć pacjen ta oraz ro dzaj i wy nik za sto so wa ne go le cze nia ope ra cyj ne go.Wy ni ki. Na pod sta wie ob ser wa cji kli nicz nej obej mu ją cej okres 2-5 lat od za bie gu ope ra cyj ne go przed stawio no ro dza je i wy ni ki za sto so wa ne go le cze nia ope ra cyj ne go.Wnioski. 1. Zła ma nia szyj ki ko ści pro mie nio wej u dzie ci do ty czą głów nie pa cjen tów w wie ku mło dzień -czym i wcze snosz kol nym, a li nia zła ma nia roz cią ga się w ob rę bie chrząst ki wzro sto wej. 2. Uzy ska ne wy ni ki le cze nia po zwa la ją na stwier dze nie, że za mknię ta re po zy cja zła ma nia szyj ki ko ści pro mie nio wej ze śród sz pi kową jej sta bi li za cją (ESIN) skut ku je bra kiem po wi kłań i wcze śniej szym po wro tem ru chów w sta wie łok cio wym. Słowa kluczowe: złamania, kość promieniowa, dzieci SUMMARYBackground. Injuries to the ulnar joint area are common musculoskeletal injuries in children. Among them, proximal radial bone fractures are characterized by a variety of treatment methods applied and a risk of complications.Objective. The aim of the present paper is to present the types and treatment results of proximal radial bone fractures in children.Material and methods. The present study is based on data obtained from the medical histories of 28 patients treated in the years 2006-2010. The clinical parameters analysed included the extent of bone fragment displacement, age and sex of the patient, and type and result of the operative treatment.Results. Types and results of the operative treatment are presented based on post-operative clinical followup of 2 to 5 years.Conclusions. 1. Paediatric radial neck fractures occur primarily in adolescents and children at early school age, and the fracture line extends within the growth plate area. 2. The treatment results allow us to conclude that closed reduction of a radial neck fracture with in tramedullary stabilization (ESIN) eliminates com plications and provides for earlier restoration of the range of motion in the ulnar joint.

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“…3 The debate about the value of comparison views continues, 4 and although it may be questionable to submit the child to another dose of radiation, easy access to a photograph or radiograph displaying the normal anatomy is often helpful. Arthrography, CT and MRI are all capable of giving much more detail as to the nature of the injury, but, as with so much other 'hi-tech' equipment, we may be subjected to information overload.…”

mentioning

confidence: 99%

Elbow Injuries in Childhood – A Source of Disquiet

Eastwood

2001

The Journal of Bone and Joint Surgery. British volume

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Evaluation of the Role of Comparison Radiographs in the Diagnosis of Traumatic Elbow Injuries

Cited by 44 publications

References 0 publications

Comparison views to diagnose elbow injuries in children: a survey of Canadian non-pediatric emergency physicians

Comparison views to diagnose elbow injuries in children: a survey of Canadian non-pediatric emergency physicians

Operative treatment of radial neck fractures in children

Elbow Injuries in Childhood – A Source of Disquiet

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