Straight leg elevation to rule out pelvic injury

Bolt, Caroline; O'Keeffe, Francis; Finnegan, P.; Dickson, Kristofer; Smit, De Villiers; Fitzgerald, Mark; Mitra, Biswadev

doi:10.1016/j.injury.2017.10.009

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…The most meaningful criterion is the lack of pelvic pain (sensitivity 91.8% and specificity 94.2%) [32]. The study of Bolt et al (2018) confirms the importance of the straight leg raise and the pelvis pain. Patients with blunt pelvic trauma, GCS 15, and pelvic fracture always showed a positive straight leg raise test and pelvic pain (sensitivity and NPV = 100%) [33].…”

Section: Pelvicmentioning

confidence: 80%

A critical look at the value of clinical examination in polytraumatized patients

Pliske¹,

Lucas²,

Schmidt³

et al. 2018

J Transl Sci

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Background and question:The Advanced Trauma Life Support (ATLS) offers a concept for the treatment of severely injured patients. In the so-called "primary survey", the patients are first examined clinically by "A-E". Subsequently, a CT scan will be performed to make accurate diagnosis. But what benefit do the clinical examinations have if a CT is performed immediately afterwards? Are the examinations just a waste of time or do they provide important information? Method: Systematic mesh-term research on pubmed.com with 62 studies to compare the latest literature on the value of clinical examinations with ATLS recommendations.Results: Relevant airway problems can directly threaten the patient and should be quickly diagnosed and fixed. Clinical examination of the cervical spine has poor sensitivity and should be avoided. The examination for hemato-/pneumothorax after blunt and penetration trauma shows a middle sensitivity but a good negative and positive predictive value. If a serious thoracic injury is suspected, a thoracic puncture or a chest tube should be done. Internal bleeding is difficult to diagnose clinically and often cannot be treated without surgical or radiological intervention. The CT scan should be done promptly and time delays by numerous clinical examinations should be avoided. Unstable pelvic fractures can be well diagnosed, depending on the technique used. If the pelvis is unstable a pelvic sling should be applied to avoid a "C-problem". Intracranial and spinal injuries cannot be diagnosed clinically. If suspected, a CT scan should be performed. During a prolonged examination of the undressed patient, the body temperature can decrease, which may be accompanied by deterioration in blood coagulation. Conclusion:The extent of the physical examination in the shock room, immediately before the CT scan, should be taken individually. With exception of airway and breathing problems, most diagnoses can only be reliably detected and treated after the CT scan..

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Section: Pelvicmentioning

confidence: 80%

A critical look at the value of clinical examination in polytraumatized patients

Pliske¹,

Lucas²,

Schmidt³

et al. 2018

J Transl Sci

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Screening bei Schmerz der Hüftregion

Maurer

2024

Clinical Reasoning Der Unteren Extremität

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Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

et al. 2022

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Background Inappropriate and wasteful use of health care resources is a common problem, constituting 10–34% of health services spending in the western world. Even though diagnostic imaging is vital for identifying correct diagnoses and administrating the right treatment, low-value imaging—in which the diagnostic test confers little to no clinical benefit—is common and contributes to inappropriate and wasteful use of health care resources. There is a lack of knowledge on the types and extent of low-value imaging. Accordingly, the objective of this study was to identify, characterize, and quantify the extent of low-value diagnostic imaging examinations for adults and children. Methods A scoping review of the published literature was performed. Medline-Ovid, Embase-Ovid, Scopus, and Cochrane Library were searched for studies published from 2010 to September 2020. The search strategy was built from medical subject headings (Mesh) for Diagnostic imaging/Radiology OR Health service misuse/Medical overuse OR Procedures and Techniques Utilization/Facilities and Services Utilization. Articles in English, German, Dutch, Swedish, Danish, or Norwegian were included. Results A total of 39,986 records were identified and, of these, 370 studies were included in the final synthesis. Eighty-four low-value imaging examinations were identified. Imaging of atraumatic pain, routine imaging in minor head injury, trauma, thrombosis, urolithiasis, after thoracic interventions, fracture follow-up and cancer staging/follow-up were the most frequently identified low-value imaging examinations. The proportion of low-value imaging varied between 2 and 100% inappropriate or unnecessary examinations. Conclusions A comprehensive list of identified low-value radiological examinations for both adults and children are presented. Future research should focus on reasons for low-value imaging utilization and interventions to reduce the use of low-value imaging internationally. Systematic review registration: PROSPERO: CRD42020208072.

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Straight leg elevation to rule out pelvic injury

Cited by 3 publications

References 17 publications

A critical look at the value of clinical examination in polytraumatized patients

A critical look at the value of clinical examination in polytraumatized patients

Screening bei Schmerz der Hüftregion

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

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