• Michael J Fahr, Laura P James, Jason R Beck, and Charles A James.
• Department of Emergency Medicine, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, USA.
• South. Med. J. 2003 Mar 1;96(3):234-9.

BackgroundThe objective of this study was to evaluate the accuracy of digital imaging in the diagnosis of toddler's fractures.MethodsMedical records for a 9.4-year period were reviewed to locate children whose initial radiographs were interpreted as normal by a pediatric radiologist and whose subsequent bone scans or follow-up radiographs showed toddler's fractures. Radiographs from these children (ie, positive controls) and from children without toddler's fractures (ie, negative controls) were digitized to create a film bank that was reviewed by a panel of 14 physicians with various medical backgrounds. Medical records were reviewed for demographic information, findings on history and physical examination, and radiographic and laboratory tests.ResultsPediatric radiology physicians correctly diagnosed 73.2 +/- 5.4% of the digitized images, as compared with pediatric emergency physicians, 66.7 +/- 6.5% and residents/fellows, 57.1 +/- 6.9%.ConclusionDigitized images may be helpful in evaluating limping children with suspected toddler's fractures, possibly eliminating the need for further diagnostic studies.

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