Emergency medicine journal : EMJ
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A short-cut review was carried out to establish whether ultrasound or plain radiography is a more sensitive diagnostic modality for slipped capital femoral epiphysis. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 2. The clinical bottom line is that ultrasonography is more sensitive then radiography for diagnosing slipped capital femoral epiphysis based on the results of small studies.
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Case Reports
BET 1: What is the significance of a 'boggy' (soft) scalp haematoma in head-injured children?
A short-cut review was carried out to establish whether the presence of a soft (boggy) scalp haematoma predicts the presence of intracranial injury in head-injured children. Three studies were directly relevant to the question. ⋯ In the one study that directly addressed the three-part question, it was concluded to warrant CT imaging. Since that time, however, concern regarding the risks associated with irradiation of children may challenge a strategy of imaging otherwise asymptomatic children with no other indication for CT imaging.
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Few studies have looked at how obesity affects injury outcomes among vehicle occupants involved in traffic collisions. ⋯ Findings from this study suggest that obese vehicle drivers are more likely to die from traffic collision-related injuries than non-obese occupants involved in the same collision. Education is needed to improve seat belt use among obese people, as is research to understand the potential role of comorbidities in injury outcomes.
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Head injuries across all age groups represent an extremely common emergency department (ED) presentation. The main focus of initial assessment and management rightly concentrates on the need to exclude significant pathology, that may or may not require neurosurgical intervention. Relatively little focus, however, is given to the potential for development of post-concussion syndrome (PCS), a constellation of symptoms of varying severity, which may bear little correlation to the nature or magnitude of the precipitating insult. This review aims to clarify the aetiology and terminology surrounding PCS and to examine the mechanisms for diagnosing and treating.