[Clinical examination of the pelvis in patients with multiple traumas is unreliable].
BACKGROUND
The primary examination of a seriously injured patient is often done according to the Advanced Trauma Life Support concept. This concept calls for routine x-rays of the chest, pelvis and cervical spine. We have seen a tendency in Norway towards selective use of the pelvic film according to trauma mechanism and physical findings, even in patients with multiple traumas.


METHODS
Four cases illustrate the risk of missing serious injuries in patients with multiple injuries if routine pelvic x-ray is omitted. A review of the literature confirms that routine pelvic x-ray may be omitted only if the patient is alert, has a negative physical pelvic examination, and no other distracting painful injuries.


CONCLUSIONS
Early x-ray of the pelvis should still be a routine in patients with multiple injuries, but may be omitted in patients with normal consciousness, no distracting painful injuries and no pain on examination of the pelvis.
Ortopedisk avdeling, Hammerfest sykehus.
Houman
H
Charani
Torben
T
Wisborg
Kari Schrøder
KS
Hansen
Guttorm
G
Brattebø
Liv Berit
LB
Stenseth
D000058:Accidental Falls; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000209:etiology; D010384:Pelvic Bones / Q000000981:diagnostic imaging* / Q000293:injuries; D011859:Radiography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*