Radiographic detection of gravel in soft tissue

Annals of Emergency Medicine
C D ChisholmD R Nelson

Abstract

We sought to quantify the detectable size of varying compositions of gravel using a cadaveric chicken leg wound model and standard plain-film two-view radiographs. We conducted a randomized, blinded, descriptive study with the assistance of faculty from the emergency medicine and radiology residency programs of a private urban teaching hospital. A standardized wound was created in each of 160 cadaver chicken legs. Zero, one, or two pieces of gravel of four differing compositions, ranging in size from .25 to 2.0 mm, were inserted into the wounds as determined with computer-generated randomization. The legs were then radiographically imaged (anteroposterior and lateral views). Three faculty physicians independently interpreted the radiographs to determine the number of foreign bodies and rated the ease of visibility. We calculated sensitivity, specificity, and interobserver reliability. The accuracy with which gravel was detected ranged from an average of 97.7% for 2-mm and 1-mm particles to less than 75% for .5-mm and .25-mm particles. Visibility ratings were also lower for particles in the smaller ranges. Sensitivity was greater for the emergency physicians than for the radiologists, but their specificity was lower. Salt-and-pe...Continue Reading

References

Jan 1, 1991·The Journal of Hand Surgery·R C RussellO Suliman
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Citations

Mar 13, 2003·Emergency Medicine Clinics of North America·Otilia Capellan, Judd E Hollander
Oct 26, 2010·Emergency Medicine Clinics of North America·Carlos F García-GubernMichael C Bond
Aug 28, 2007·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Georg EggersJoachim Mühling
Apr 3, 2007·Emergency Medicine Clinics of North America·Robert B Blankenship, Todd Baker
Feb 11, 2012·European Journal of Radiology·Kai TaoZi-hua Wang

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