Diagnostic Utility of Conventional Radiography in Head Injury

Chawla, Hitesh

doi:10.7860/jcdr/2015/13842.6133

Cited by 23 publications

(21 citation statements)

References 10 publications

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“…However, both authors used either the CT or X-ray scans as the gold standard, not osteological analysis. Sensitivities for the detection of adult skull fractures appear to be better than those found in the present study, with sensitivities of 85.4% reported for CT scans [20] and 71.4% for X-rays [21]. The lower sensitivities found in the present study for pediatric compared to adult skull fractures is likely due to the presence of unfused sutures and incomplete fractures in pediatric skulls, which may make fracture detection more difficult [22].…”

Section: Repeatabilitycontrasting

confidence: 83%

A comparison of computed tomography, X‐ray and Lodox^® scans in assessing pediatric skull fractures using piglets

Spies

Steyn

Brits

2020

Journal of Forensic Sciences

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Skull fractures are common in children both due to abuse and accidental incidences. The accurate detection of these fractures may therefore be critical. The aim of this study was to investigate the reliability of CT, X‐ray, and Lodox® scans, the latter which has not previously been evaluated and is commonly employed in South Africa, in detecting the number, location and type of pediatric skull fractures. Blunt force trauma was inflicted with a mallet on ten piglet skulls, which were CT, X‐ray, and Lodox® scanned and then macerated. The number, location, and type of skull fractures visible using each imaging modality, and on the cleaned skulls, were recorded. Sensitivities and specificities of each method were calculated. For fracture number and location, CTs had a sensitivity of 47.3%, X‐rays 22.4% and Lodox® 23.3%. For fracture type, sensitivities were 46.1%, 16.6%, and 17.8% for CT, X‐ray, and Lodox®, respectively. Specificities were high (92.5%–100%) which reduces the risk of incorrectly diagnosing fractures. However, low sensitivities increase the risk of failing to identify fractures and possible victims of abuse. Osteological analysis should preferably be the method of choice when evaluating pediatric skull trauma, and CTs should be used when osteological analysis is not feasible. If CT scanners are not available, X‐rays and Lodox® may have to be used. In these cases, additional radiographic views of the skull are imperative and may increase the sensitivity of these methods, although they are not recommended to detect exact pediatric skull fracture number, location, and type.

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Section: Repeatabilitycontrasting

confidence: 83%

A comparison of computed tomography, X‐ray and Lodox^® scans in assessing pediatric skull fractures using piglets

Spies

Steyn

Brits

2020

Journal of Forensic Sciences

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“…In contrast to the current study, Chawla et al, revealed that when compared with the CT scan, X-ray was unable to detect 11.9 percent of head fractures thus claiming that X-ray had little role in the detection of skull fractures compared with CT scan and autopsy. 15 In comparison, we had a much lower rate of missed skull fractures. In deceased patients, an autopsy is considered as a more definitive approach for the identification of skull fractures, as reported by Anand et al 16 and Goyal et al 17 However, in living patients, detection of fractures is more challenging.…”

Section: Discussionmentioning

confidence: 82%

The Role of Radiology (X-Ray versus Computed Tomography) in Medicolegal Cases Presented at a Tertiary Care Hospital in Pakistan

Altaf¹,

Razaque²,

Hussain³

et al. 2021

Pak J Neurol Surg

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Objectives: A prospective observational study was aimed to assess the role of plain radiographs and computed tomography in detecting head injuries presented at the medicolegal office at the Forensics and Radiology Departments, Gambat Medical Hospital, Sindh. Material and Methods: All cases referred from the Medicolegal Office (MLO) with head injury were included. All victims underwent X-ray head and computed tomography skull was done with 1 or 1.5 cm thick axial sections without administration of intravenous contrast. The radiological reports of X-ray head and CT scans were documented and comparatively evaluated. Results: Mean age was 38.63 ± 3.91 years. In 51 (45.13%) cases, X-ray was able to detect skull fracture, while CT scan detected 64(56.64%) skull fractures. There were 54 (84.3%) true positives, 3 (2.6%) false positives, 10(8.8%) false negatives, and 40 (40.7%) true negatives. The accuracy of X-ray to detect skull fracture was 88.50%. Conclusion: X-ray had a sensitivity and specificity of 84.38% and 93.88%, respectively. It is a reliable tool to detect skull fractures in victims of assault in comparison with CT scans. X-ray is also associated with low dose radiation exposure as compared with CT scan which delivers 70 times more exposure than the former.

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“…5. Finally, radiographs are known to be unreliable for the detection of cranial fractures even in the best of circumstances (see, e.g., Chawla et al, 2015;Le & Gean, 2006;Sim et al, 2017), especially, if the radiograph shows the opposite side of the fracture, as is the case here (radiograph of the left side of the Cioclovina cranium). This is because the features of the proximal side, including blood vessel grooves, can obscure those of the distal side.…”

Section: The Illustrations Published Bymentioning

confidence: 86%

Cioclovina fractures: Reply to Soficaru and Trinkaus: Perimortem versus postmortem damage: The recent case of Cioclovina 1, Am J Phys Anthropol 2020 172, 135–139

Kranioti

Grigorescu

Harvati

2020

American J Phys Anthropol

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Diagnostic Utility of Conventional Radiography in Head Injury

Cited by 23 publications

References 10 publications

A comparison of computed tomography, X‐ray and Lodox^® scans in assessing pediatric skull fractures using piglets

A comparison of computed tomography, X‐ray and Lodox^® scans in assessing pediatric skull fractures using piglets

The Role of Radiology (X-Ray versus Computed Tomography) in Medicolegal Cases Presented at a Tertiary Care Hospital in Pakistan

Cioclovina fractures: Reply to Soficaru and Trinkaus: Perimortem versus postmortem damage: The recent case of Cioclovina 1, Am J Phys Anthropol 2020 172, 135–139

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Diagnostic Utility of Conventional Radiography in Head Injury

Cited by 23 publications

References 10 publications

A comparison of computed tomography, X‐ray and Lodox® scans in assessing pediatric skull fractures using piglets

A comparison of computed tomography, X‐ray and Lodox® scans in assessing pediatric skull fractures using piglets

The Role of Radiology (X-Ray versus Computed Tomography) in Medicolegal Cases Presented at a Tertiary Care Hospital in Pakistan

Cioclovina fractures: Reply to Soficaru and Trinkaus: Perimortem versus postmortem damage: The recent case of Cioclovina 1, Am J Phys Anthropol 2020 172, 135–139

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A comparison of computed tomography, X‐ray and Lodox^® scans in assessing pediatric skull fractures using piglets

A comparison of computed tomography, X‐ray and Lodox^® scans in assessing pediatric skull fractures using piglets