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Comparison views to diagnose elbow injuries in children: a survey of Canadian non-pediatric emergency physicians

Published online by Cambridge University Press:  21 May 2015

Shawn Dowling ,
Ken Farion  and
Tammy Clifford
Shawn Dowling*
Affiliation:
University of Calgary, Calgary, Alta
Ken Farion
Affiliation:
Department of Pediatrics and Emergency Medicine, Children’s Hospital of Eastern Ontario, Ottawa, Ont., and University of Ottawa, Ottawa
Tammy Clifford
Affiliation:
Chalmers Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ont.
*
407–321 10th St. NW, Calgary AB; 403 283-1322, sdowling@ucalgary.ca

Abstract

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Objectives:

Elbow injuries in children are a common presenting complaint to the emergency department. Although radiography is a valuable tool in the diagnosis of this injury, x-rays of the injured elbow are inherently difficult to interpret. As a result, comparison views of the uninjured arm have traditionally been recommended to provide an anatomically “normal” radiograph. Recent studies have questioned the use of comparison views in the pediatric emergency department. The primary objective of this study was to determine current practices of non-pediatric emergency physicians in the use of comparison views for the diagnosis of elbow injuries in children.

Methods:

A self-administered mail survey was sent to 300 randomly selected emergency physicians, using the Canadian Association of Emergency Physicians database.

Results:

Two hundred and forty-two (81%) responses were received; 26 were excluded based on pre-determined criteria. Of eligible respondents, 95% ordered comparison views selectively and 64% of these physicians ordered comparison views infrequently. Eighty-eight percent found the comparison views to be “rarely” to “sometimes” useful. Forty-seven percent of respondents stated that they were only “somewhat” confident when interpreting x-rays of a child's elbow.

Conclusion:

This survey demonstrates that non-pediatric emergency physicians are using comparison views selectively for elbow injuries in children, despite being only “somewhat” confident in interpreting the x-rays.

Keywords

elbowcomparison radiographscomparison x-rayspediatrics
Type
Pediatric EM • Pédiatrie d’urgence
Information
Canadian Journal of Emergency Medicine , Volume 7 , Issue 4 , July 2005 , pp. 237 - 240
Copyright
Copyright © Canadian Association of Emergency Physicians 2005

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