Pediatric Dog Bites: When Is Imaging Necessary?
New study concludes that imaging for diagnosing pediatric dog bites can provide valuable information in some cases but is generally overused.
Imaging techniques are often used when diagnosing dog bite injuries in children; however, there are no well-established guidelines for determining whether they are necessary. Even though imaging may provide valuable information in some cases, it is also costly and exposes children to ionizing radiation -- thus its use should be limited.
In a recent review study, researchers looked at whether imaging was overused when assessing pediatric dog bite injuries. They focused on the two most common imaging modalities used: maxillofacial CT scans and limb radiographs.
The researchers claim that because the majority of imaging studies were negative, showing no evidence of bone injury, imaging studies are overused in the initial workup of children with dog bite injuries.
However, the researchers also argue that there are certain patient populations and injury patterns that might necessitate certain types of imaging. For instance, maxillofacial CT scans can diagnose facial fractures not reliably caught by physical exams, especially in children under two years old. When it comes to dog bites to the limbs, hand radiographs are more likely to yield positive results than long limb radiographs.
Overall, this study shows that it is possible to institute guidelines for ordering imaging studies in pediatric dog bite patients. Such guidelines would reduce radiation exposure and cost of care by limiting imaging to only those patients and injuries that require it.