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Value of postmortem thoracic CT over radiography in imaging of pediatric rib fractures.
[child syndrome]
Studies
have
reported
that
thoracic
CT
may
provide
greater
sensitivity
compared
with
radiography
in
detection
of
pediatric
rib
fractures
and
fracture
healing
.
The
additional
sensitivity
afforded
by
thoracic
CT
may
have
medicolegal
implications
where
abuse
is
suspected
.
To
determine
the
additional
value
of
postmortem
thoracic
CT
compared
with
radiography
in
detecting
pediatric
rib
fractures
,
and
fracture
healing
,
using
autopsy
findings
as
a
gold
standard
.
We
retrospectively
reviewed
56
coroner
's
cases
with
postmortem
radiography
and
CT
thoracic
survey
.
All
studies
underwent
primary
interpretation
by
one
or
two
radiologists
.
The
study
radiologist
independently
reviewed
all
images
from
13
patients
with
positive
findings
on
radiography
,
CT
or
autopsy
.
Sensitivity
and
specificity
between
observers
and
imaging
modalities
were
compared
.
Primary
interpretation
:
Fractures
were
recognized
on
radiography
in
5
/
12
patients
who
had
fractures
found
at
autopsy
,
and
on
CT
in
8
/
12
patients
.
In
total
,
29
%
(
24
/
83
)
of
fractures
were
reported
on
radiography
,
and
51
%
(
52
/
101
)
of
fractures
were
reported
on
CT
.
Study
radiologist
:
Fractures
were
recognized
on
radiography
in
7
/
12
patients
who
had
fractures
found
at
autopsy
,
and
on
CT
in
11
/
12
patients
.
In
total
,
46
%
(
38
/
83
)
of
fractures
were
reported
on
radiography
,
and
85
%
(
86
/
101
)
of
fractures
were
reported
on
CT
.
P
ostmortem
thoracic
CT
provides
greater
sensitivity
than
radiography
in
detecting
pediatric
rib
fractures
,
most
notably
in
anterior
and
posterior
fractures
.
However
,
the
degree
of
improvement
in
sensitivity
provided
by
CT
might
depend
on
observer
experience
.
Diseases
Validation
Diseases presenting
"rib fractures"
symptom
child syndrome
familial hypocalciuric hypercalcemia
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