ABSTRACT
PURPOSE OF THE STUDY: There is a controversy over whether or not routine comparative x-rays should be prescribed for young children with bone and joint trauma. We conducted a retrospective analysis to assess the contribution of such x-rays. MATERIAL AND METHODS: The series included 203 children aged less than fifteen years who had experienced bone and joint trauma. Two junior orthopedic surgeons, two senior orthopedic surgeons and two pediatric radiologists reread the x-rays to establish the diagnosis, using comparative x-rays to make any necessary correction of the diagnosis. The surgeons were asked to propose a therapeutic strategy for each diagnosis and the radiologists were asked to judge the value of the comparative x-rays. RESULTS: The comparative x-rays were found to be reliable in only 87.5% of the cases, and were useful for diagnosis in only 8.8%. There were statistically significant differences depending on the localization, the patient's age, and the physician's experience. DISCUSSION: Systematic use of comparative x-rays should be discouraged. Only trauma affecting the elbow in older children can, in particular cases, warrant prescription of comparative x-rays.
