Can Pediatric Thoracolumbar Fractures Be Identified Clinically?

A validated rule does not exist for determining whether to conduct thoracolumbar plain radiography or computed tomography (CT) in pediatric or adult trauma patients. In a prospective, observational study, researchers evaluated the ability of pediatric emergency physicians and trauma surgeons to detect thoracolumbar fractures based on clinical features and clinical suspicion. During a 1-year period, investigators enrolled 228 consecutive patients (age range, 2 months to 18 years) who presented to a level I pediatric trauma center with back pain and risk for thoracolumbar spine injury. Clinicians recorded clinical findings and degree of clinical suspicion (none or low vs. moderate or high) on a data sheet before radiologic examination of the …