title: Usefulness of the skyline view in the assessment of acute knee trauma in children.
abstract: We report a retrospective analysis of all cases of acute knee injuries in children presenting to the Winnipeg Children's Hospital, University of Manitoba, between Jan. 1, 1994, and Jan. 1, 1995. The mechanism of injury was recorded and all 3 radiographic views (i.e., anterioposterior, lateral and skyline) were available for 171 of 256 total cases. We found a significant association between mechanism of injury and visualization of damage on skyline view radiographs (p < 0.01). The skyline view showed damage in only 1 of the 158 cases involving direct or indirect injury not involving subluxation or dislocation. However, damage was visualized on skyline view radiographs in 7 (54%) of the 13 cases that included a history of subluxation or dislocation. We conclude that in acute knee trauma in children, a skyline view radiograph of the patella should be obtained only when the mechanism of injury includes subluxation or dislocation. When the mechanism does not suggest subluxation or dislocation, the skyline view is unlikely to reveal damage; it adds unnecessary radiation, cost and possible added discomfort for the child.
authors.affiliation: Section of Orthopedic Surgery, Children's Hospital of Winnipeg Health Sciences Centre, 840 Sherbrook St., Winnipeg, MB R3A 1S1.
authors.forename: G Brian
authors.initials: GB
authors.lastname: Black
authors.forename: Azim
authors.initials: A
authors.lastname: Mustapha
authors.forename: Martin
authors.initials: M
authors.lastname: Reed
authors.forename: Bryce
authors.initials: B
authors.lastname: Henderson
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging; D007718:Knee Injuries / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies