title: How useful is the skull x-ray examination in trauma?
abstract: Abnormalities were detected only in 24 (2.3%) of 1053 skull X-ray examinations performed in cases of suspected head trauma, at a cost of $1461 per positive finding. Only in six cases (0.6%) was treatment influenced by the radiological findings. Skull X-ray examination is indicated if a depressed fracture, compound fracture, or radio-opaque foreign body is suspected, and these patients are reliably selected by certain clinical criteria. The skull X-ray film is not a reliable guide to the presence or extent of intracranial injury, nor is it a substitute for careful clinical evaluation, observation and re-evaluation. The medicolegal implications of this restrictive policy are discussed.
mesh_terms: D000368:Aged; D001315:Australia; D001930:Brain Injuries / Q000000981:diagnostic imaging; D003365:Costs and Cost Analysis; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging* / Q000628:therapy; D005554:Forensic Medicine; D006801:Humans; D008297:Male; D011859:Radiography; D012886:Skull / Q000000981:diagnostic imaging*; D012887:Skull Fractures / Q000000981:diagnostic imaging; D014600:Utilization Review