Emergency pediatric imaging: changes over the years. Part II

To assess the diagnostic value of ultrasound compared to CT in evaluating acute abdominal pain of different causes in children 10 years of age and under, hospital records and imaging files of 4052 patients under age of 10 who had imaging for abdominal pain were reviewed. One-hundred-thirty-two patients (3 %), (74 males/58 females) who underwent ultrasound and CT within 24 h were divided by age: group I, ages 0-48 months (25 patients); group II, 49-84 months (53 patients); and group III, 85-120 months (54 patients). Diagnoses at ultrasound, CT, and discharge were compared. Cases of a change in diagnosis following CT and impact of the changed diagnosis on patient management were assessed. Non-diagnostic ultrasound or a diagnostic conundrum was present in a small percentage (3 %) of our patients. In the group of patients imaged with two modalities, CT changed the diagnosis in 73/132 patients (55.3 %). Patient management changed in 63/132 patients (47.7 %). CT changed the diagnosis in 46/64 patients with surgical conditions (71.8 %, p < 0.001). Among patients with surgical conditions, the difference between ultrasonography (US) and CT diagnoses was significant in groups 2 (p = 0.046) and 3 (p = .001). The impact of the change in diagnosis in surgical patients imaged with two modalities was significant in the group as a whole and in each age group separately. Non-diagnostic or equivocal US in a small percentage of patients is probably sufficient to justify the additional radiation burden.

show abstract

“…However, several articles reported increase in use of abdominal CT in pediatric emergency departments in recent years [19,20].…”

Section: Discussionmentioning

confidence: 98%

Diagnostic value of CT compared to ultrasound in the evaluation of acute abdominal pain in children younger than 10 years old

2015

View full text Add to dashboard Cite

show abstract

“…The acutely limping child can be a diagnostic dilemma for clinicians. Most commonly, the acute limp is caused by minor trauma or self-limiting benign conditions but can also be caused by limb-threatening or life-threatening etiologies [2][3][4][5][6]. The cause of limp can usually be determined by a careful history and physical examination.…”

Section: Summary Of Literature Reviewmentioning

confidence: 99%

ACR Appropriateness Criteria® Acutely Limping Child Up To Age 5

Safdar

Rigsby

Iyer

et al. 2018

Journal of the American College of Radiology

View full text Add to dashboard Cite

Imaging plays in important role in the evaluation of the acutely limping child. The decision-making process about initial imaging must consider the level of suspicion for infection and whether symptoms can be localized. The appropriateness of specific imaging examinations in the acutely limping child to age 5 years is discussed with attention in each clinical scenario to the role of radiography, ultrasound, nuclear medicine, computed tomography, and magnetic resonance imaging. Common causes of limping such as toddler's fracture, septic arthritis, transient synovitis, and osteomyelitis are discussed. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

show abstract

Bildgebung beim akuten Abdomen im Kindes- und Jugendalter

Wünsch¹,

Wunsch²

2015

Weiterbildung Radiologie

View full text Add to dashboard Cite

Emergency pediatric imaging: changes over the years. Part II

Cited by 8 publications

References 17 publications

Diagnostic value of CT compared to ultrasound in the evaluation of acute abdominal pain in children younger than 10 years old

Diagnostic value of CT compared to ultrasound in the evaluation of acute abdominal pain in children younger than 10 years old

ACR Appropriateness Criteria® Acutely Limping Child Up To Age 5

Bildgebung beim akuten Abdomen im Kindes- und Jugendalter

Contact Info

Product

Resources

About