title: Digital radiography in the diagnosis of Toddler's fracture.
abstract: BACKGROUND
  The objective of this study was to evaluate the accuracy of digital imaging in the diagnosis of toddler's fractures.
  
  
  METHODS
  Medical records for a 9.4-year period were reviewed to locate children whose initial radiographs were interpreted as normal by a pediatric radiologist and whose subsequent bone scans or follow-up radiographs showed toddler's fractures. Radiographs from these children (ie, positive controls) and from children without toddler's fractures (ie, negative controls) were digitized to create a film bank that was reviewed by a panel of 14 physicians with various medical backgrounds. Medical records were reviewed for demographic information, findings on history and physical examination, and radiographic and laboratory tests.
  
  
  RESULTS
  Pediatric radiology physicians correctly diagnosed 73.2 +/- 5.4% of the digitized images, as compared with pediatric emergency physicians, 66.7 +/- 6.5% and residents/fellows, 57.1 +/- 6.9%.
  
  
  CONCLUSIONS
  Digitized images may be helpful in evaluating limping children with suspected toddler's fractures, possibly eliminating the need for further diagnostic studies.
authors.affiliation: Department of Emergency Medicine, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fahr
authors.forename: Laura P
authors.initials: LP
authors.lastname: James
authors.forename: Jason R
authors.initials: JR
authors.lastname: Beck
authors.forename: Charles A
authors.initials: CA
authors.lastname: James
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008511:Medicine; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D013038:Specialization; D013978:Tibial Fractures / Q000000981:diagnostic imaging*