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Oblique radiographs of the chest in nonaccidental trauma

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Abstract

Purpose: Oblique radiographs of the chest were added to our skeletal survey for nonaccidental trauma to determine if these views improved our ability to diagnose rib fractures accurately. Methods: Seventy-three patients were evaluated with skeletal surveys for suspected child abuse. The chest films were reviewed independently by three radiologists as two separate sets, one with the frontal and lateral views only and one including the two oblique views. At the end of the study, consensus readings of all two- and four-view sets were reached and used as the true interpretations. Results: In 14 patients, positive rib fractures were identified by consensus. The accuracy, sensitivity, and specificity for each radiologist were greater with the four-view sets than with the two-view sets. In some children, rib fractures considered equivocal by two-view evaluation were called confidently as positive or negative with the additional views. Conclusion: The addition of oblique radiographs improves rib fracture evaluation in children suspected of having suffered nonaccidental trauma, increasing sensitivity, specificity, and accuracy as well as the radiologists' confidence.

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Ingram, J., Connell, J., Hay, T. et al. Oblique radiographs of the chest in nonaccidental trauma. Emergency Radiology 7, 42–46 (2000). https://doi.org/10.1007/s101400050009

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  • DOI: https://doi.org/10.1007/s101400050009

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