Document Detail


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.
MedLine Citation:
PMID:  15609065     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Anthony M Avellino; Fred A Mann; M Sean Grady; Jens R Chapman; Richard G Ellenbogen; Tord D Alden; Sohail K Mirza
Related Documents :
6814575 - Unusual injury? recent injury in normal children and children with suspected non-accide...
2346155 - Bunk bed injuries.
1994685 - Skateboarding injuries in children. a second wave.
2783095 - Paediatric bicycle injuries.
15097765 - The electronic visual acuity tester: testability in preschool children.
22112335 - How are babies fed? a pilot study exploring primary school children's perceptions of in...
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2004-12-18
Journal Detail:
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:
Created Date:  2005-02-07     Completed Date:  2005-06-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  122-7     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle, WA 98105, USA. anthony.avellino@seattlechildrens.org
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  Isolation, identification and expression of a Fasciola hepatica cDNA encoding a 2.9-kDa recombinant ...
Next Document:  Sodium hyaluronate regulating angiogenesis during Achilles tendon healing.