Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?

Abstract Introduction Concurrent X‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand (FOOSH) is intended to minimise the risk of an undetected co‐occurring injury and is typically performed on patients aged 0–10 years. The purpose of this st...

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Main Authors: Daniel G Sgualdino, Michael J Neep, Kelly Spuur, Clarissa Hughes
Format: Article
Language:English
Published: Wiley 2022-12-01
Series:Journal of Medical Radiation Sciences
Subjects:
Online Access:https://doi.org/10.1002/jmrs.614
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author Daniel G Sgualdino
Michael J Neep
Kelly Spuur
Clarissa Hughes
author_facet Daniel G Sgualdino
Michael J Neep
Kelly Spuur
Clarissa Hughes
author_sort Daniel G Sgualdino
collection DOAJ
description Abstract Introduction Concurrent X‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand (FOOSH) is intended to minimise the risk of an undetected co‐occurring injury and is typically performed on patients aged 0–10 years. The purpose of this study was to explore the benefit of this strategy and to identify if age could provide evidence for imaging. Methods A 12‐month retrospective review of all X‐ray examinations of the wrist, forearm and distal humerus of patients aged 0–10 years referred from the Emergency Department of Logan Hospital, Queensland was undertaken. The frequency, type and location of radiographic abnormalities and the requested examinations region of interest (ROI), referral notation and patient's age were recorded. Analysis was made by descriptive statistics. Results Four hundred and seventy‐six examinations met the studies inclusion criteria, 4.8% (n = 23) identified an abnormality outside of the documented ROI. On review of the admission and treatment notes, 1.7% (n = 8) were deemed to have detected traumatic abnormalities as a direct outcome of concurrent imaging. No age‐related evidence for imaging was identified. Conclusion This study demonstrates limited benefit (1.7%) to concurrent imaging following a FOOSH. The results suggest that a thorough physical evaluation of the paediatric upper limb performed by the referrer is sufficient to accurately guide X‐ray imaging. These findings have the potential to positively impact a reduction in the number of X‐rays performed on paediatric patients and in turn contribute to limiting radiation dose. Further studies may be beneficial in verifying the study's findings.
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spelling doaj.art-172ac865e29247529f497f7e34bac3542022-12-22T02:45:25ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092022-12-0169443143810.1002/jmrs.614Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?Daniel G Sgualdino0Michael J Neep1Kelly Spuur2Clarissa Hughes3School of Dentistry and Medical Sciences Charles Sturt University Wagga Wagga New South Wales AustraliaDepartment of Medical Imaging Logan Hospital Meadowbrook Queensland AustraliaSchool of Dentistry and Medical Sciences Charles Sturt University Wagga Wagga New South Wales AustraliaSchool of Nursing, Paramedicine and Healthcare Sciences Charles Sturt University Wagga Wagga New South Wales AustraliaAbstract Introduction Concurrent X‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand (FOOSH) is intended to minimise the risk of an undetected co‐occurring injury and is typically performed on patients aged 0–10 years. The purpose of this study was to explore the benefit of this strategy and to identify if age could provide evidence for imaging. Methods A 12‐month retrospective review of all X‐ray examinations of the wrist, forearm and distal humerus of patients aged 0–10 years referred from the Emergency Department of Logan Hospital, Queensland was undertaken. The frequency, type and location of radiographic abnormalities and the requested examinations region of interest (ROI), referral notation and patient's age were recorded. Analysis was made by descriptive statistics. Results Four hundred and seventy‐six examinations met the studies inclusion criteria, 4.8% (n = 23) identified an abnormality outside of the documented ROI. On review of the admission and treatment notes, 1.7% (n = 8) were deemed to have detected traumatic abnormalities as a direct outcome of concurrent imaging. No age‐related evidence for imaging was identified. Conclusion This study demonstrates limited benefit (1.7%) to concurrent imaging following a FOOSH. The results suggest that a thorough physical evaluation of the paediatric upper limb performed by the referrer is sufficient to accurately guide X‐ray imaging. These findings have the potential to positively impact a reduction in the number of X‐rays performed on paediatric patients and in turn contribute to limiting radiation dose. Further studies may be beneficial in verifying the study's findings.https://doi.org/10.1002/jmrs.614FOOSH injuryforearmgeneral radiographymedical imagingpaediatric imagingradiology
spellingShingle Daniel G Sgualdino
Michael J Neep
Kelly Spuur
Clarissa Hughes
Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?
Journal of Medical Radiation Sciences
FOOSH injury
forearm
general radiography
medical imaging
paediatric imaging
radiology
title Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?
title_full Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?
title_fullStr Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?
title_full_unstemmed Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?
title_short Is there benefit to concurrent x‐ray imaging of the wrist, forearm and elbow in paediatric patients following a fall on the outstretched hand?
title_sort is there benefit to concurrent x ray imaging of the wrist forearm and elbow in paediatric patients following a fall on the outstretched hand
topic FOOSH injury
forearm
general radiography
medical imaging
paediatric imaging
radiology
url https://doi.org/10.1002/jmrs.614
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