Imaging in trauma in limited-resource settings: A literature review

Trauma is a leading health problem and cause of death throughout both the developed and the developing world. In Africa and South Africa in particular, trauma-related injury has an increased morbidity and mortality when compared to the rest of the world, with numbers approaching a staggering two to six times the global average. Rapid diagnosis is key when it comes to identification and treatment of traumatic injuries. In locations that are limited in finances, infrastructure, and resources, a stepwise approach to imaging in trauma can lead to decreased morbidity and mortality. Tailored recommendations for imaging trauma in resource-limited settings can lead to improved diagnostics and treatment and in turn, decrease mortality.

A systematic literature review was conducted, using a compilation of English-language articles found on PubMed, EMBASE, Medline, and Cochrane Library searches relevant to imaging in trauma. A total of 31 journals articles, published from 1991 to 2017 were reviewed.

From the search, 26 original articles were selected and reviewed in detail, as well as an additional five original research articles.

As imaging continues to evolve, its importance in the role of diagnostic algorithms in trauma settings is important. In most settings, imaging is relied upon as an adjunct to the primary survey. In most developed settings, CT scan remains the mainstay for imaging in trauma, but in limited-resource settings, other imaging studies such as LODOX, X-ray, and especially ultrasound can play a large role. As ultrasound is directly related to user operation, data are limited and variable; more research as this field evolves will be beneficial.