Imaging evaluation of children after falls from a height: review of 45 cases

Article Abstract:

Childhood injuries and death are often the result of accidents involving a fall from a height, especially in urban areas. The types of injuries caused by these falls differ from those seen in motor vehicle accidents and other causes of blunt injuries. No previous study has specifically examined these injuries and their radiographic appearance. This study evaluated the clinical data and radiographic imaging findings for 45 children who had fallen from a height. The children were all under 12 years of age and had fallen from a height of at least 10 feet. Results found most of the children were between two and four years old, most had fallen from a window that did not have a properly installed window guard, and most of the falls occurred in the summer. Minor injuries most commonly found were bruises and lacerations. Twenty-one patients suffered bone fractures, with seven patients having multiple fractures. Most fractures occurred in the arms and legs (20 patients) with most involving one leg. Fractures in the arms more often involved both arms. Head injuries were found in 19 patients, while abdominal injuries were found in only six patients. There was no correlation between the height of the fall and the types and severity of injuries. The results showed children are more likely to survive falls than are adults and are less severely injured, although children suffer more head injuries than do adults. This is probably because of the fact that children's heads are proportionally larger than adults'. Children suffered fewer injuries to the pelvis and abdomen than adults. These results indicate that children who fall from heights have different patterns of injury from adult patterns, and therefore the protocols for examining them should be different. Abdominal, pelvic, lower extremity, and head X-rays and computed tomographic (CT) scans are not automatically required in these cases and need only be performed when their need is indicated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Injuries, Complications and side effects, Children, Pediatric injuries, Head injuries, CT imaging, CAT scans, Falls (Accidents), Accidental falls, Fractures (Injuries), Extremities (Anatomy)

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Absorbed dose in imaging: why measure it?

Article Abstract:

X-rays used for diagnosis expose patients to low levels of radiation. The total amount of absorbed radiation a patient receives is heavily monitored and regulated. This is done because it has been assumed that such exposure increases the risk for cancer. There are a number of reasons to continue close monitoring and regulation of absorbed doses in imaging. Risks that have not been detected by research may still exist. Close monitoring has also helped in the development of diagnostic imaging techniques and procedures. Careful measurement and monitoring has prevented a laxity in the performance of imaging that could result in high exposure doses that would be risky. An article by Suleiman in the March 1991 issue of Radiology examines procedures for measuring exposure of the upper gastrointestinal (GI) tract from fluoroscopic examination. Measuring skin doses at the entrance of the fluoroscope overestimates actual exposure of sensitive organs and tissues inside the GI tract. This article examines a new technique for measuring internal exposure. Results showed exposure to be low in the GI tract from fluoroscopic examination. The sample size was small, but the research is an important beginning in obtaining more accurate measurements of internal exposure from fluoroscopic examinations. A second article in the same issue of Radiology, by Cagnon and colleagues, examines exposure from automatic-exposure-controlled fluoroscopy. Some units allow the automatic rate limit to be exceeded by using an override control device. These devices can cause too much exposure in the hands of a radiologist not familiar with them. Heavier regulation of these devices may be needed. Excessive radiation exposure is not a problem with diagnostic imaging today because of careful monitoring and regulation, and it is best that such precautions continue in the future. (Consumer Summary produced by Reliance Medical Information, Inc.)

Safety and security measures, Risk factors, Physiological aspects, Radiation, Radiation (Physics), Cancer, X-rays, Fluoroscopy, editorial

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