title: Relative radio-opacity of commonly consumed fish species in South East Queensland on lateral neck x-ray: an ovine model.
abstract: OBJECTIVE
  To determine the relative radio-opacity on plain x-ray of bones of fish species commonly consumed in South East Queensland.
  
  
  METHODS
  A cadaveric sheep model was used to mimic the soft tissues of a human neck. Bones of 10 fish species were placed in the paratracheal tissues and adjacent to the larynx. X-rays were taken and the images (including four control images with no bones) were incorporated into a Microsoft PowerPoint presentation to be interpreted by emergency specialists and registrars. Observers were blinded to which specimens contained fishbones and which did not.
  
  
  METHODS
  Sensitivity and specificity of plain x-rays for detecting impacted fishbones.
  
  
  RESULTS
  Significant interobserver variability was identified. Despite this, the overall specificity of plain x-rays was 90%. The sensitivity of the technique was 79% overall, but varied significantly between fish species.
  
  
  CONCLUSIONS
  Lateral soft tissue neck x-ray is an appropriate screening tool in cases of a suspected impacted fishbone. If a fishbone is identified on x-ray, the patient should be referred for endoscopy without further imaging. X-ray may be of limited value in cases of Dory or Spanish mackerel bone ingestion. In such cases, a computed tomography scan should be the first-line investigation.
authors.affiliation: Alice Springs Hospital, Alice Springs, NT, Australia. willdavies72@hotmail.com
authors.forename: William R A
authors.initials: WR
authors.lastname: Davies
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Bate
mesh_terms: D000818:Animals; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D004195:Disease Models, Animal; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D006801:Humans; D009333:Neck / Q000000981:diagnostic imaging*; D010614:Pharynx / Q000000981:diagnostic imaging*; D011859:Radiography; D015203:Reproducibility of Results; D017747:Seafood; D012680:Sensitivity and Specificity; D012756:Sheep