ArticlePediatric radiology2019
The added value of a second read by pediatric radiologists for outside skeletal surveys.
Article in Pediatric radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 32 citations in OpenAlex.
- Outcomes of indeterminate fractures identified on skeletal surveys obtained during non-accidental trauma evaluations.Child abuse & neglect · 2026Article
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- Can metaphyseal variations in the distal femurs and proximal tibias be distinguished from classic metaphyseal lesions?Pediatric radiology · 2025Article
- Using deep learning for estimation of time-since-injury in pediatric accidental fractures.Pediatric radiology · 2025Article
- Artificial intelligence (AI) for paediatric fracture detection: a multireader multicase (MRMC) study protocol.BMJ open · 2024Article
- Age-specific Patterns of Intimate Partner Violence Related Injuries in US Emergency Departments.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2024Article
- Machine learning to identify distal tibial classic metaphyseal lesions of infant abuse: a pilot study.Pediatric radiology · 2022Article
- Transfer patient imaging: discordances between community and subspecialist emergency radiologists.Emergency radiology · 2022Article
- Rate of resident recognition of nonaccidental trauma: how well do residents perform?Pediatric radiology · 2021Article
- A call to action: education of radiology residents in child abuse imaging.Pediatric radiology · 2021Article
- Fractures of child abuse.Pediatric radiology · 2021Review
- The radiology report in child abuse.Pediatric radiology · 2021Review
- Musculoskeletal Outside Interpretation (MOI-RADS): an automated quality assurance tool to prospectively track discrepancies in second-opinion interpretations in musculoskeletal imaging.Skeletal radiology · 2021Article
- Providing second-opinion interpretations of pediatric imaging: embracing the call for value-added medicine.Pediatric radiology · 2021Review
- Pediatric cervical spine injuries on CT: difference in accuracy of interpretations by pediatric versus non-pediatric radiologists.Emergency radiology · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFractures are the second most common finding in non-accidental trauma after cutaneous signs. Interpreting skeletal surveys could be challenging as some fractures are subtle and due to anatomical variations that can mimic injuries.
objectiveTo determine the effect of a second read by a pediatric radiologist of skeletal surveys for suspected non-accidental trauma initially read at referring hospitals by general radiologists. MATERIALS AND
methodsIn 2016 and 2017, we identified all patients referred to our children's hospital with previous surveys performed and read at a community hospital by an outside radiologist. We excluded patients older than 3 years and studies performed at a children's hospital. The surveys were reviewed by a pediatric radiologist with the printed outside report available. Surveys with disagreement between outside read and pediatric radiologist read were reviewed by a second pediatric radiologist. A disagreement in the second read included only definite discrepant findings agreed upon by both pediatric radiologists. The Fisher exact test was performed to compare the ratio of discrepancies between readers in normal and abnormal surveys.
resultsTwo hundred twenty-five surveys were performed (120 male) at 62 referring hospitals, with a mean patient age of 10.5 months (range: 5 days-3 years). The outside read identified fractures in 104/225 (46.2%) surveys. Thirty-seven of the 225 (16.4%) contained discrepancies in interpretation (n=111). Most of these disagreements (29/37, 78.4%) resulted in a significant change in the report. There was a significant (P<0.0001) difference between disagreement rate in outside read negative (4/111, 3.2%) and positive surveys (34/104, 31.7%). The second read identified additional fractures in 22/225 (9.8%) of the surveys and disagreed with first-read fractures in 17/256 (7.6%). Four of 19 (21.1%) classic metaphyseal lesions diagnosed by the outside read were normal variants; 18 classic metaphyseal lesions were missed by the outside read.
conclusionsThis study supports second reads by pediatric radiologists of skeletal surveys for non-accidental trauma.
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