Is pelvis x-ray essential in stable trauma patients? Step towards lowering the treatment cost

J Pak Med Assoc. 2019 Mar;69(Suppl 1)(1):S33-S36.

Abstract

Objective: To determine the diagnostic accuracy of clinical examination in detecting pelvic fractures in patients with blunt trauma..

Methods: The cross-sectional prospective study was conducted at Aga Khan University Hospital, Karachi, from January to June 2015, and comprised alert, awake blunt-trauma patients. Pelvis examination findings were compared to routine pelvic X-rays. SPSS 19 was used for data analysis..

Results: Of the 133 patients, 122 (92%) were males. Overall mean age was 37 ±14.2 years. There were 14 (10%) patients who were true positives with pelvic fracture diagnosis on both clinical examination and pelvic X-ray, while 14 (10%) were false negative on examination. Clinical examination missed 2 patients with evidence of fracture on X-ray and were considered false positive. Besides, 103 (77.4%) patients were true negative as both clinical exam and X-ray showed no evidence of fracture.

Conclusion: Omitting pelvic X-ray in the recommended protocol can avoid unnecessary financial burden and reduce undesirable radiation exposure..

Keywords: Blunt trauma, Stable patients, Pelvic fractures, Clinical examination.

MeSH terms

  • Adult
  • Cost Control
  • Cross-Sectional Studies
  • Diagnostic Errors* / economics
  • Diagnostic Errors* / prevention & control
  • Diagnostic Errors* / statistics & numerical data
  • Female
  • Fractures, Bone / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Pakistan
  • Patient Acuity
  • Pelvic Bones* / diagnostic imaging
  • Pelvic Bones* / injuries
  • Physical Examination / methods*
  • Radiography* / economics
  • Radiography* / methods
  • Radiography* / standards
  • Radiologic Health
  • Unnecessary Procedures / economics
  • Wounds, Nonpenetrating / diagnosis*