Grady Yoder MD, Presenter: Nothing to Disclose

John Odita MD, Abstract Co-Author: Nothing to Disclose

Lou Smith MD, Abstract Co-Author: Nothing to Disclose

Gloria Caldito PhD, Abstract Co-Author: Nothing to Disclose

David Gordon MD, Abstract Co-Author: Nothing to Disclose

Martin Pilat MS, Abstract Co-Author: Nothing to Disclose

Mindy Robinson MS, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To determine the usefulness of routine plain radiographic pelvic examinations in children presenting with blunt abdominal trauma

355 children aged 1-16 years admitted to our Level trauma center over a three year period constitute the material for this presentation. For each patient, the following were extracted from the medical records: age, sex, mechanism of injury, Injury severity score(ISS) and Glasgow Coma Scale(GCS) scores as well as the presence of hematuria. Clinial examination of the pelvis in search of iliac or pubic bone fracture was also made. The plain pelvic radiograph was evaluated for the presence, site , type and extent of pelvic fractures. The need for blood transfusion within the first 24 hours of admission was noted. Significant predictors for pelvic injuries were determined using simple (for univariate analyses) and multiple(for multivariate analyses)logistic regression models. a 5% level of confidence was used for all statistical tests

The average age of presentation was 9 years. 206 patients were under 12 years. The average GCS and ISS were 12.7 and 12.5 respectively. 22(6.2%) patients presented with pevic fractures. Using separate univariate analysis the following factors were significant for pelvic fracutes: age greater than 12 years (pWith multivariate analysis, only pelvic examination and requirement for blood transfusion were determined to be independent predictors for pediatric pelvic fractures. The pelvic examiation had a sensitivity and specificity of 55% and 97% respectively while its positive and negative predictive values were 52% and 97% respectively

A pelvic radiograph is not indicated in children less than 12 years(1) if the physical examination is normal(2)if there is no hematuria (3)if there is no requirement for blood tranfusion (4) and if the mechanism is other than motor vehicle crash. Physical examination is not always sufficient to exclude pelvic fractures

Yoder, G, Odita, J, Smith, L, Caldito, G, Gordon, D, Pilat, M, Robinson, M, et al, , Are Plain Pelvic Radiographs Necessary in All Cases of Pediatric Blunt Abdominal Trauma?.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4406872.html