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Study objective: To determine how well emergency physicians predict the results of shoulder radiographs. Methods: This prospective trial at a teaching community hospital ED with boardcertified attending emergency physicians enrolled 105 patients presenting with a chief complaint of shoulder pain. In these patients, attending emergency physicians were asked to predict the likelihood of an abnormal finding on radiographs, defined as the presence of a fracture, dislocation, or acrominclavicular separation, using a scale of "high" (>50%), "moderate" (5% to 50%) and "low" (<5%) suspicion. Estimates were recorded after ordenng but before viewing the radiograph. Results: Of the 105 cases, suspicion was rated as high in 20 cases (19%), whereas in 24 cases (23%) and 61 cases (58%) suspicion was moderate and low, respectively. When suspicion for an abnormal radiograph was high, 90% were abnormal; when moderate, 17%; and when low, 0%. Overall, when all radiographs were reviewed, 21% (22/105) were abnormal with 77% fractures, 14% dislocations, and 9% AC separations. Conclusion: Shoulder radiographs had a relatively low rate of positivity as used in our community hospital ED. A low clinical sus

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Author

MT Nguyen

Publisher

Elsevier Science; Elsevier ; Mosby Inc.; Elsevier BV (ISSN 1097-6760)

Published

1999

Language

EN

Field

Medicine (Health Sciences)