Standard imaging in the emergency department in geriatric patients with immobilizing pelvic pain after low-energy trauma or without trauma: X-ray vs. computed tomography.
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All Authors
Abdalmaqsoud, H.
Sehmisch, S.
Giannoudis, V.
Liodakis, E.
LTHT Author
Giannoudis, Vassilis
LTHT Department
Orthopaedics
Non Medic
Publication Date
2024
Item Type
Journal Article
Language
Subject
Subject Headings
Abstract
PURPOSE: Geriatric pelvic ring injuries, evaluated solely by X-ray, are often misclassified or even missed. This can result in prolonged immobilization and persistent pelvic pain. The aim of this study was to assess the sensitivity and specificity of X-ray imaging in patients aged >= 70 years with immobilizing pelvic pain.
METHODS: 107 geriatric patients (23 males, 84 females) with immobilizing pain after traumatic or atraumatic causes were included in this retrospective study. 91 patients had an anteroposterior (AP) X-ray of the pelvis and after that a computed tomography (CT) of the pelvis. All patients were treated in a level 1 trauma center from December 2018 to September 2020. The mean age was 83.07 +/- 6.08 years.
RESULTS: The overall evaluation of the diagnostic performance of AP Pelvic X-ray imaging in the study population compared to the CT pelvis ("gold standard") resulted in a sensitivity of (2.7 %) and a specificity of (94.4 %). Specific for pelvic ring fractures in the study population there was a sensitivity of (3.4 %) and a specificity of (94.4 %).
CONCLUSION: The results highlights issues with the AP Pelvic X-ray as the diagnostic tool of choice in this study population, confirming the findings of previous studies on the underestimated problem of osteoporotic pelvic ring fractures in geriatric patients. This again confirms the need for a new optimized diagnostic algorithm, which takes into account the differences of the orthogeriatric patient cohort.
Journal
Injury