Necessity of routine pelvic radiograph in the pediatric blunt trauma patient

Dana W.E. Ramirez, Jennifer J. Schuette, Vinita Knight, Elizabeth Johnson, Justin Denise, Allen R. Walker

Research output: Contribution to journalArticlepeer-review

Abstract

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: Clinical indicators may be useful in determining the need for pelvic radiographs in awake and alert pediatric blunt trauma patients.

Original languageEnglish (US)
Pages (from-to)935-940
Number of pages6
JournalClinical pediatrics
Volume47
Issue number9
DOIs
StatePublished - Nov 1 2008

Keywords

  • Blunt trauma
  • Pediatric trauma
  • Pediatrics
  • Pelvic X ray
  • Pelvic fracture
  • Pelvic injury
  • Pelvic radiograph
  • Routine radiographs
  • Trauma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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