| The misdiagnosis of acute cervical spine injuries and fractures in infants and children: the 12-year experience of a level I pediatric and adult trauma center. | |
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MedLine Citation:
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PMID: 15609065 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective was to determine the frequency of acute cervical spine injuries and fractures that were misdiagnosed in infants and children (< or =14 years) initially evaluated at a pediatric and adult urban level I trauma center. METHODS AND RESULTS: This was a retrospective, single-institution, case series of pediatric cervical spine injuries and fractures that were misdiagnosed during initial emergency room imaging evaluation. "Misdiagnosed" cases were those cases whose imaging studies initially obtained in the emergency room were misinterpreted based on reevaluation by a senior trauma radiologist blinded to the initial results. Nineteen percent (7 out of 37) were misdiagnosed on initial emergency room imaging evaluation. Five percent were true "missed" fractures, and 14% were "normal and/or developmental variants" read as fractures or dislocation. CONCLUSIONS: The error rate for infants and children < or =8 years was 24%, and for children > or =9 years was 15%. The occiput to C2 region was the most common site of diagnostic error. The most common factors predisposing to misdiagnosis were unfamiliarity with pediatric cervical spine anatomy, failure to recognize normal variants seen during growth and development, and suboptimal conventional film techniques. |
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Authors:
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Anthony M Avellino; Fred A Mann; M Sean Grady; Jens R Chapman; Richard G Ellenbogen; Tord D Alden; Sohail K Mirza |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2004-12-18 |
Journal Detail:
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Title: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Volume: 21 ISSN: 0256-7040 ISO Abbreviation: Childs Nerv Syst Publication Date: 2005 Feb |
Date Detail:
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Created Date: 2005-02-07 Completed Date: 2005-06-13 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8503227 Medline TA: Childs Nerv Syst Country: Germany |
Other Details:
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Languages: eng Pagination: 122-7 Citation Subset: IM |
Affiliation:
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Department of Neurological Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle, WA 98105, USA. anthony.avellino@seattlechildrens.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Cervical Vertebrae / pathology Child Child, Preschool Diagnostic Errors* Female Humans Infant Injury Severity Score Magnetic Resonance Imaging / methods Male Mass Screening / methods Retrospective Studies Review Literature as Topic Spinal Fractures / diagnosis*, epidemiology* Spinal Injuries / diagnosis*, epidemiology Tomography, X-Ray Computed / methods Trauma Centers* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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