Radiographic imaging use for lacerations: A necessity or over-imaging?

Area of Science:

• Emergency Medicine
• Radiology
• Trauma Care

Background:

• Lacerations frequently lead to Emergency Department visits.
• Radiographs are often the initial imaging for suspected foreign bodies (FBs) or fractures.
• Current practices lack standardized guidelines for radiographic use in laceration assessment.

Purpose of the Study:

• To investigate the diagnostic yield of radiographic imaging for various laceration presentations.
• To evaluate the effectiveness of radiographs in detecting foreign bodies and fractures in patients with lacerations.

Main Methods:

• Retrospective cross-sectional study analyzing patient data from two hospitals over 12 months.
• Data included anatomical region, injury mechanism, clinical question, and imaging findings.
• Pearson's Chi-Square test assessed imaging outcome distributions.

Main Results:

• Only 10% of radiographs for lacerations revealed new abnormal findings.
• Fractures were identified in 7% and foreign bodies in 3% of cases.
• Inconclusive or suspected foreign body findings were more common than confirmed cases; unclear injury mechanisms yielded fewer significant findings.

Conclusions:

• Radiographs have a low diagnostic yield for lacerations, emphasizing the importance of physical examination.
• Imaging should be guided by clinical judgment, with caution advised for foreign body detection.
• Radiographs are effective for fractures but limited for foreign bodies in laceration cases.