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Routine comparison views in cases of suspected extremity injury in children have not been adequately substantiated, in the authors' opinion. Three hundred such cases were reviewed, with pediatric radiologists requesting comparison views of the uninjured side in 8%. In no case did the comparison view change the initial diagnosis. When the initial interpretation is made by pediatric radiologists, selective use of comparison views is more cost-efficient and delivers less radiation to patients and personnel, compared to obtaining them routinely in all cases.

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