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Emergency Radiology

, Volume 8, Issue 4, pp 207–212 | Cite as

Comparison views for subtle physeal injury in the pediatric ankle

  • C. H. Chong-Han
  • D. A. Yngve
  • J. Y. Lee
  • E. P. Hendrick
  • S. D. John
  • L. E. Swischuk
ORIGINAL ARTICLE

Abstract

This study addresses whether physicians should obtain routine comparison views to detect subtle fractures. Twenty-two cases of Salter-Harris I fractures of the fibula and 16 cases of nonfracture ankle injury were viewed by 26 radiology and orthopedic physicians. For each case, participants made a diagnosis and indicated whether they were highly certain, moderately certain, or uncertain in that diagnosis for the injured side alone and then for the injured side by comparison with the uninjured side (comparison view). Overall film reading accuracy was 43 % without comparison views vs 65 % with comparison views; accuracy for nonphyseal injuries was 65 % vs 88 %, accuracy for physeal injuries was 27 % vs 49 % (all p < 0.0001, X2 test). Comparison views increased certainty scores by 0.26 on a 2-point scale (p = 0.0002, t-test). Accuracy and certainty in the diagnosis of ankle injuries improved significantly with comparison views, supporting the opinion that comparison views are valuable for the accurate detection of subtle physeal injury.

Keywords Comparison views – Extremity – Injuries – Bones – Fractures – Pediatric radiology 

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Copyright information

© American Society of Emergency Radiology 2001

Authors and Affiliations

  • C. H. Chong-Han
    • 1
  • D. A. Yngve
    • 2
  • J. Y. Lee
    • 3
  • E. P. Hendrick
    • 4
  • S. D. John
    • 5
  • L. E. Swischuk
    • 6
  1. 1.Department of Radiology, Brown University, Providence, Rhode Island, USAUS
  2. 2.Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555–0353, USA e-mail: dyngve@utmb.edu Tel.: + 1-4 09-7 72 35 05 Fax: + 1-4 09-7 72 42 53US
  3. 3.Department of Radiology, Washington University, St. Louis, Missouri, USAUS
  4. 4.Department of Radiology, University of Texas Medical Branch, Galveston, Texas, USAUS
  5. 5.Department of Radiology and Pediatrics, University of Texas at Houston, Texas, USAUS
  6. 6.Department of Radiology and Pediatrics, University of Texas Medical Branch, Galveston, Texas, USAUS

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