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- Talk
- 10/06/2022
- CANADA
Pediatric Musculoskeletal Radiographs: Anatomy and Fractures Prone to Diagnostic Error Among Emergency Physicians
Description
In this presentation, Dr. Mark Camp from SickKids discusses his experience as a clinical advisory board member for 7D and the importance of accurate diagnoses in pediatric musculoskeletal (MSK) injuries. He emphasizes that early and precise identification of these injuries can often be managed with simple techniques, resulting in excellent outcomes. However, misdiagnoses can lead to significant delays in treatment, potentially resulting in serious surgical interventions and long-term disabilities.
Dr. Camp highlights the challenges in interpreting radiographs of immature skeletons due to incomplete ossification. He discusses research aimed at identifying the radiographic factors that complicate diagnostic interpretation for emergency physicians and the need for targeted educational interventions to reduce missed pediatric MSK injuries. Over six years, a web-based educational platform called ImageSim collected data on diagnostic interpretations from over 244 physicians, including pediatric emergency medicine fellows, who provided interpretations on 1850 pediatric MSK radiographs.
Through rigorous statistical analysis, the study uncovered a 23% diagnostic error rate, with a significant portion being false negatives—misdiagnoses that delay necessary referrals for treatment. Dr. Camp shares examples of common anatomical misinterpretations, including nutrient vessels mistaken for fractures, and highlights that injuries involving unossified areas, such as the physis or growth plates, are particularly challenging to diagnose.
The presentation concludes with a discussion of actionable learning opportunities identified in the study to enhance the accuracy of radiographic interpretation among emergency physicians, with plans to extend this research to orthopedic residents and trainees.