Limited Sensitivity for Plain Anteroposterior Pelvic Imaging
(HealthDay News) — For children with pelvic fractures or dislocations after blunt trauma, plain anteroposterior pelvic radiographs have limited sensitivity, according to a study published online July 29 in the Annals of Emergency Medicine.
Maria Y. Kwok, MD, MPH, from the Columbia University Medical Center in New York City, and colleagues conducted a prospective multicenter observational study involving 12,044 pediatric patients (aged <18 years) with blunt torso trauma in the Pediatric Emergency Care Applied Research Network. Plain anteroposterior pelvic radiographs were compared to the final diagnosis of pelvic fractures or dislocations, as documented by orthopedic physicians.
The researchers found that 3.7% of the patients (452 patients) had pelvic fractures or dislocations. Of these patients, 14% underwent operative intervention, and, on initial presentation, 4.7% had age-adjusted hypotension. Among the 382 patients who underwent plain anteroposterior pelvic radiography, the sensitivity was 78, 92, and 82%, respectively, for pelvic fractures or dislocations, for patients undergoing operative intervention, and for hypotension.
"Plain anteroposterior pelvic radiograph has a limited sensitivity for identifying children with pelvic fractures or dislocations after blunt trauma, including a significant proportion of children with hypotension and those who undergo operative intervention," the authors write. "Plain anteroposterior pelvic radiographs should not be relied on as the sole diagnostic test in patients considered at high risk of pelvic fractures or dislocations."