RT Journal Article
SR Electronic
T1 Detection of pneumothorax by accident and emergency officers and radiologists on single chest films.
JF Archives of Emergency Medicine
JO Arch Emerg Med
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 343
OP 346
DO 10.1136/emj.10.4.343
VO 10
IS 4
A1 F Aitchison
A1 A Bleetman
A1 P Munro
A1 D McCarter
A1 A W Reid
YR 1993
UL http://emj.bmj.com/content/10/4/343.abstract
AB To assess whether an accurate diagnosis of pneumothorax can be made on a single chest film, 233 pairs of inspiratory (I) and expiratory (E) chest films taken in an accident and emergency (A&E) department for suspected pneumothorax were reviewed by two A&E officers and three radiologists. The films were assessed for the presence of pneumothorax by viewing the I film in isolation and, after an interval, by viewing the paired I and E films together. Fifty-four of the patients had a pneumothorax. The five observers missed 23 pneumothoraces (8.5% of total) on the I film alone which were correctly diagnosed on the paired I and E films, the three radiologists missed 10/162 pneumothoraces on the I film alone which were correctly identified on the I and E films (6%) and the two A&E officers 13/108 (12.5%). The use of a single inspiratory chest film for suspected pneumothorax could result in pneumothoraces being missed, particularly by less experienced observers and therefore we believe that paired I and E films should continue to be used routinely for suspected pneumothorax.