title: Utility of complete trauma series radiographs in alert pediatric patients presenting to Emergency Department of a Tertiary Care Hospital.
abstract: OBJECTIVE
  To assess the utility of trauma series radiographs in the management of alert pediatric patients with traumatic injury and to ascertain whether it is necessary to acquire the entire trauma series in these children.
  
  
  METHODS
  A total of 176 consecutive children below the age of 15 years and having Glasgow Coma Scale score greater than 12, who presented to the emergency department of a tertiary care hospital with a history of recent trauma, were retrospectively reviewed. All the children had undergone a thorough clinical examination followed by complete trauma series radiographs, according to the American College of Surgery guidelines.
  
  
  RESULTS
  A total of 558 radiographs were reviewed by a consultant pediatric radiologist including 528 trauma series radiographs and 30 additional radiographs. Among the trauma series radiographs, 35 (6.63 %) had evidence of injury; 24 (4.54 %) and 11 (2.08 %) involving the chest and pelvic regions, respectively. All children with normal physical examination had normal cervical spine and chest radiographs. Among the 11 positive pelvic X-rays, only two had radiological signs of injury in the absence of localizing physical signs, and all these children were less than 3 years of age. In all the remaining cases, children had localizing signs on physical examination. Out of the 30 additional X-rays, 27 (90 %) had radiological evidence of injury.
  
  
  CONCLUSIONS
  The routine use of entire radiological trauma series in alert pediatric patients with a normal physical examination has a very low yield. In these children, the localizing signs and symptoms can help us in determining the specific radiological examination to be utilized.
authors.affiliation: Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan, Tariq.alam@aku.edu.
authors.forename: T
authors.initials: T
authors.lastname: Alam Khan
authors.forename: Y
authors.initials: Y
authors.lastname: Jamil Khattak
authors.forename: M
authors.initials: M
authors.lastname: Awais
authors.forename: A
authors.initials: A
authors.lastname: Alam Khan
authors.forename: Y
authors.initials: Y
authors.lastname: Husen
authors.forename: N
authors.initials: N
authors.lastname: Nadeem
authors.forename: A
authors.initials: A
authors.lastname: Rehman
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000293:Adolescent; D017677:Age Distribution; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D004204:Joint Dislocations / Q000000981:diagnostic imaging; D008297:Male; D010808:Physical Examination / Q000379:methods; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging; D011030:Pneumothorax / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology; D063128:Tertiary Health Care; D013898:Thoracic Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging* / Q000453:epidemiology