Errors in Imaging Patients in the Emergency Setting

Overview

Journal Br J Radiol

Publisher Oxford University Press

Specialty Radiology

Date 2016 Feb 4

PMID 26838955

Citations 37

Authors

Antonio Pinto

Alfonso Reginelli

Fabio Pinto

Giuseppe Lo Re

Federico Midiri

Carlo Muzj

Luigia Romano

Luca Brunese

Affiliations

Soon will be listed here.

Abstract

Emergency and trauma care produces a "perfect storm" for radiological errors: uncooperative patients, inadequate histories, time-critical decisions, concurrent tasks and often junior personnel working after hours in busy emergency departments. The main cause of diagnostic errors in the emergency department is the failure to correctly interpret radiographs, and the majority of diagnoses missed on radiographs are fractures. Missed diagnoses potentially have important consequences for patients, clinicians and radiologists. Radiologists play a pivotal role in the diagnostic assessment of polytrauma patients and of patients with non-traumatic craniothoracoabdominal emergencies, and key elements to reduce errors in the emergency setting are knowledge, experience and the correct application of imaging protocols. This article aims to highlight the definition and classification of errors in radiology, the causes of errors in emergency radiology and the spectrum of diagnostic errors in radiography, ultrasonography and CT in the emergency setting.

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References

Caranci F, Tedeschi E, Leone G, Reginelli A, Gatta G, Pinto A . Errors in neuroradiology. Radiol Med. 2015; 120(9):795-801. DOI: 10.1007/s11547-015-0564-7. View

Gruen R, Jurkovich G, McIntyre L, Foy H, Maier R . Patterns of errors contributing to trauma mortality: lessons learned from 2,594 deaths. Ann Surg. 2006; 244(3):371-80. PMC: 1856538. DOI: 10.1097/01.sla.0000234655.83517.56. View

Pinto A, Pinto F, Faggian A, Rubini G, Caranci F, Macarini L . Sources of error in emergency ultrasonography. Crit Ultrasound J. 2013; 5 Suppl 1:S1. PMC: 3711733. DOI: 10.1186/2036-7902-5-S1-S1. View

Caranci F, Cicala D, Cappabianca S, Briganti F, Brunese L, Fonio P . Orbital fractures: role of imaging. Semin Ultrasound CT MR. 2012; 33(5):385-91. DOI: 10.1053/j.sult.2012.06.007. View

Johnson P, Scott W, Gayler B, Lewin J, Fishman E . The CT scout view: does it need to be routinely reviewed as part of the CT interpretation?. AJR Am J Roentgenol. 2014; 202(6):1256-63. DOI: 10.2214/AJR.13.10545. View

Reber P, Schmied B, Seiler C, Baer H, Patel A, Buchler M . Missed diaphragmatic injuries and their long-term sequelae. J Trauma. 1998; 44(1):183-8. DOI: 10.1097/00005373-199801000-00026. View

Scaglione M, Romano L, Bocchini G, Sica G, Guida F, Pinto A . Multidetector computed tomography of pancreatic, small bowel, and mesenteric traumas. Semin Roentgenol. 2012; 47(4):362-70. DOI: 10.1053/j.ro.2012.05.005. View

Caleo O, Bocchini G, Paoletta S, Ierardi A, Scionti A, Tonerini M . Spontaneous non-aortic retroperitoneal hemorrhage: etiology, imaging characterization and impact of MDCT on management. A multicentric study. Radiol Med. 2015; 120(1):133-48. DOI: 10.1007/s11547-014-0482-0. View

Hernandez J, Swischuk L, Yngve D, Carmichael K . The angled buckle fracture in pediatrics: a frequently missed fracture. Emerg Radiol. 2004; 10(2):71-5. DOI: 10.1007/s10140-003-0288-1. View

10.

Chang P, Schooler G, Lee E . Diagnostic errors of right lower quadrant pain in children: beyond appendicitis. Abdom Imaging. 2015; 40(7):2071-90. DOI: 10.1007/s00261-015-0482-0. View

11.

Waeckerle J . A prospective study identifying the sensitivity of radiographic findings and the efficacy of clinical findings in carpal navicular fractures. Ann Emerg Med. 1987; 16(7):733-7. DOI: 10.1016/s0196-0644(87)80563-2. View

12.

Dominguez S, Liu P, Roberts C, Mandell M, Richman P . Prevalence of traumatic hip and pelvic fractures in patients with suspected hip fracture and negative initial standard radiographs--a study of emergency department patients. Acad Emerg Med. 2005; 12(4):366-9. DOI: 10.1197/j.aem.2004.10.024. View

13.

Wei C, Tsai W, Tiu C, Wu H, Chiou H, Chang C . Systematic analysis of missed extremity fractures in emergency radiology. Acta Radiol. 2006; 47(7):710-7. DOI: 10.1080/02841850600806340. View

14.

Samuel S, KUNDEL H, NODINE C, Toto L . Mechanism of satisfaction of search: eye position recordings in the reading of chest radiographs. Radiology. 1995; 194(3):895-902. DOI: 10.1148/radiology.194.3.7862998. View

15.

Waizenegger M, Barton N, Davis T, Wastie M . Clinical signs in scaphoid fractures. J Hand Surg Br. 1994; 19(6):743-7. DOI: 10.1016/0266-7681(94)90249-6. View

16.

Berbaum K, Franken Jr E, Dorfman D, Barloon T . Influence of clinical history upon detection of nodules and other lesions. Invest Radiol. 1988; 23(1):48-55. DOI: 10.1097/00004424-198801000-00011. View

17.

Woodring J, Lee C . The role and limitations of computed tomographic scanning in the evaluation of cervical trauma. J Trauma. 1992; 33(5):698-708. DOI: 10.1097/00005373-199211000-00019. View

18.

Lee C, Nagy P, Weaver S, Newman-Toker D . Cognitive and system factors contributing to diagnostic errors in radiology. AJR Am J Roentgenol. 2013; 201(3):611-7. DOI: 10.2214/AJR.12.10375. View

19.

Sica G, Bocchini G, Guida F, Tanga M, Guaglione M, Scaglione M . Multidetector computed tomography in the diagnosis and management of renal trauma. Radiol Med. 2010; 115(6):936-49. DOI: 10.1007/s11547-010-0565-5. View

20.

Busardo F, Frati P, Santurro A, Zaami S, Fineschi V . Errors and malpractice lawsuits in radiology: what the radiologist needs to know. Radiol Med. 2015; 120(9):779-84. DOI: 10.1007/s11547-015-0561-x. View