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Necessity of routine pelvic radiograph in the pediatric blunt trauma patient

Ramirez, Dana W E; Schuette, Jennifer J; Knight, Vinita; Johnson, Elizabeth; Denise, Justin; Walker, Allen R
BACKGROUND:Pelvic radiographs are obtained frequently in pediatric blunt trauma. The authors hypothesize that there are clinical indicators that can predict pelvic fracture on a pelvic radiograph in the pediatric blunt trauma patient with a Glasgow Coma Scale score of 14 or 15. METHODS:A retrospective case-control study of 33 patients with pelvic fractures and 63 patients without pelvic fractures was performed. RESULTS:8 evaluated clinical indicators showed that pelvic contusions and abrasions (P = .026), hip/pelvic pain (P<.001), abdominal pain and distension (P = .006), back pain (P = .080), hip held in rotation at presentation (P = .026), and femur deformity/pain (P = .002) were independently predictive of pelvic fracture. In combination, absence of hip/pelvic pain, pelvic contusions and abrasions, abdominal pain/distension, and femur deformity/pain showed a negative predictive value of 87%. CONCLUSION/CONCLUSIONS:Clinical indicators may be useful in determining the need for pelvic radiographs in awake and alert pediatric blunt trauma patients.
PMID: 18567696
ISSN: 0009-9228
CID: 3406952