دورية أكاديمية
أعرض في EDS

Are 2 Radiographic Views As Good as 3 Views to Diagnose Ankle Fractures in Children and Adolescents?

التفاصيل البيبلوغرافية
العنوان: Are 2 Radiographic Views As Good as 3 Views to Diagnose Ankle Fractures in Children and Adolescents?
المؤلفون: Abouassaly M; From the Dr Alberta Children's Hospital, Calgary, Canada., Blumetti FC; Dr Hospital Infantil Sabara, São Paulo, Brazil., Gauthier L; Dr IWK Health Centre, Halifax., Willis RB; Dr Children's Hospital of Eastern Ontario, Ottawa, Canada., Kontio K; Dr Children's Hospital of Eastern Ontario, Ottawa, Canada., Highmore K; Dr Children's Hospital of Eastern Ontario, Ottawa, Canada., Abdeen N; Dr Children's Hospital of Eastern Ontario, Ottawa, Canada., Plint AC; Dr Children's Hospital of Eastern Ontario, Ottawa, Canada., Tse S; Dr Children's Hospital of Eastern Ontario, Ottawa, Canada., Barrowman N; Dr Children's Hospital of Eastern Ontario, Ottawa, Canada., Moroz PJ; Dr Shriners Hospitals for Children Honolulu, Honolulu, HI.
المصدر: Pediatric emergency care [Pediatr Emerg Care] 2022 Sep 01; Vol. 38 (9), pp. e1508-e1511. Date of Electronic Publication: 2022 Aug 09.
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8507560 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-1815 (Electronic) Linking ISSN: 07495161 NLM ISO Abbreviation: Pediatr Emerg Care Subsets: MEDLINE
أسماء مطبوعة: Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Baltimore, Md. : Williams & Wilkins, [c1985-
مواضيع طبية MeSH: Ankle Fractures*/diagnostic imaging , Ankle Injuries*/diagnostic imaging, Adolescent ; Ankle ; Ankle Joint ; Child ; Humans ; Radiography ; Sensitivity and Specificity
مستخلص: Objectives: Ankle radiographs are among the most commonly obtained trauma images in the pediatric population, with the standard 3 views (AP/mortise [M]/lateral [L]) routinely ordered in the emergency department. The purpose of this study was to compare the diagnostic accuracy, sensitivity, and specificity of sets of 2 views (AP/L or M/L) with the standard 3 views.
Methods: One hundred twenty sets of ankle radiographs of skeletally immature patients obtained in the emergency department of a level 1 pediatric trauma center were used. These included sets with and without fractures. Sets of 3 and 2 views were reviewed by pairs of pediatric-trained orthopedic surgeons, radiologists, and emergency physicians. Each completed 3 randomized viewing sessions where all possible combinations for each set of radiographs were reviewed. Diagnoses for the 3 sets of views were compared for accuracy, sensitivity, and specificity.
Results: Overall accuracy, sensitivity, and specificity for all reviewers were as follows: AP/M/L 74%, 94%, and 90%, AP/L 71%, 90%, and 94%, as well as M/L 69%, 90%, and 91%. P values for accuracy, sensitivity, and specificity of AP/L and M/L compared with 3 views were 0.34, 0.04, and 0.52, as well as 0.04, 0.004, and 1.00, respectively.
Conclusions: In skeletally immature patients, statistically significant differences in accuracy were obtained when comparing the standard 3 AP/M/L views with more limited M/L views, suggesting that this set of 2 views is not as accurate. Differences in sensitivity of limited views were also statistically significant. Conversely, differences in accuracy between the standard 3 views and AP/Lateral views were not statistically significant. While more limited AP/L views may be comparable in accuracy and specificity and lead to dramatically decreased radiation and costs, this can be at the expense of less diagnostic sensitivity and increased risk of misdiagnosing or missing certain fractures.
Level of Evidence: Level III.
Competing Interests: Disclosure: The authors declare no conflict of interest.
(Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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تواريخ الأحداث: Date Created: 20220810 Date Completed: 20220901 Latest Revision: 20230930
رمز التحديث: 20231215
DOI: 10.1097/PEC.0000000000002810
PMID: 35947061
قاعدة البيانات: MEDLINE
الوصف
تدمد:1535-1815
DOI:10.1097/PEC.0000000000002810