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Comparison of computed tomography and chest radiography in the detection of rib fractures in abused infants.
[child syndrome]
Chest
radiographs
(
CXR
)
are
the
standard
method
for
evaluating
rib
fractures
in
abused
infants
.
Computed
tomography
(
CT
)
is
a
sensitive
method
to
detect
rib
fractures
.
The
purpose
of
this
study
was
to
compare
CT
and
CXR
in
the
evaluation
of
rib
fractures
in
abused
infants
.
This
retrospective
study
included
all
12
abused
infants
identified
from
1999
to
2004
who
had
rib
fractures
and
both
CXR
and
CT
(
8
abdomen
CTs
,
4
chest
CTs
)
.
CT
exams
had
been
performed
for
clinical
indications
,
and
were
obtained
within
one
day
of
the
CXR
.
Studies
were
reviewed
by
two
pediatric
radiologists
to
determine
the
number
,
locations
,
and
approximate
ages
of
the
rib
fractures
.
A
total
of
225
ribs
were
completely
(
192
)
or
partially
(
33
)
seen
by
CT
,
and
the
matched
ribs
on
CXR
were
used
for
the
analysis
.
The
mean
patient
age
was
2
.
5
months
(
1
.
2
-
5
.
6
)
,
with
seven
females
and
five
males
.
While
131
fractures
were
visualized
by
CT
,
only
79
were
seen
by
CXR
(
p
<
.
001
)
.
One
patient
had
fractures
only
seen
by
CT
.
There
were
significantly
(
p
<
.
05
)
more
early
subacute
(
24
vs
.
4
)
,
subacute
(
47
vs
.
26
)
,
and
old
fractures
(
4
vs
.
0
)
seen
by
CT
than
by
CXR
.
Anterior
(
42
vs
.
11
)
,
anterolateral
(
21
vs
.
12
)
,
posterolateral
(
9
vs
.
3
)
and
posterior
(
39
vs
.
24
)
fractures
were
better
seen
by
CT
than
by
CXR
(
p
<
.
01
)
.
Bilateral
fractures
were
detected
more
often
by
CT
(
11
)
than
by
CXR
(
6
)
.
While
this
study
group
is
small
,
these
findings
suggest
that
CT
is
better
than
CXR
in
visualizing
rib
fractures
in
abused
infants
.
Diseases
Validation
Diseases presenting
"bilateral fractures"
symptom
child syndrome
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