Utilization of Imaging in the Management of Pediatric Dog Bites

Abstract

Introduction:We hypothesized that imaging is overused in the initial workup of dog bite patients. To reduce radiation exposure, we aim to determine which circumstances surrounding dog bites, patient population, and injury patterns would necessitate imaging studies for management.Methods: A retrospective review was performed on all patients presenting with dog bites to our level I pediatric trauma center between 2013 and 2015. Data collected included: circumstances surrounding the injury, patient demographics, injuries, and imaging studies performed. Our analysis focused on maxillofacial and head CT scans, and plain radiographic studies of the limbs, hands, and feet. Imaging studies were considered positive if there was evidence of bony injury. Results:We identified 615 patients with dog bites, with 114 patients having had at least one imaging study performed (a total of 145 imaging studies to analyze). Only 13 (11%) patients had a positive study. In the CT scan group, 6 (22.2%) of 27 studies were positive. In the plain radiographic group, 7 (5.9%) of 118 studies were positive.Conclusions: Our review indicates that imaging studies are overused in the initial workup of these patients, and the majority of these studies are negative. This study confirms that it is feasible to institute guidelines for ordering imaging studies in dog bite patients. This will ultimately reduce radiation exposure and the cost of care for these injuries.

Pediatric Long Bone Fractures After Dog Bites: A Case Series and Systematic Review

“…Ultimately, after full-text reviews, two studies from PubMed and three from OVID were included in the final analysis (Figure 12). The five studies included were retrospective chart reviews [9][10][11][12][13]. The reviews were conducted at four level one pediatric trauma centers and two pediatric tertiary emergency departments.…”