Keywords:
Not applicable, Pathology, Radiation safety, Health policy and practice, Ultrasound, Digital radiography, CT, Emergency, Abdomen, Projection Radiography
Authors:
W. Tam; Reading/UK
DOI:
10.26044/ecr2020/C-01416
Results
The position of AXR in the diagnostic pathway of abdominal pain has not yet reached a verdict and was described as "catch 22" [10], as AXR can be used to prevent high radiation exposure of CT or as a boost of referrers' confidence, while further imaging is often needed after AXR. Despite the documented ineffectiveness of AXR for supporting a definitive diagnosis or leading to a correct treatment alternation [3, 5, 11-20] and the advancement in CT and ultrasound, there was no dramatic decrease of the AXR used [11] (Fig 1). Some advocated utilising ultrasound as a gatekeeper for CT [21] but it might not be completely pragmatic.
Only 32% of AXR requests adhered to the Royal College of Radiologists guidelines [22-23] (Fig 2), which may contribute to the high rate of further imaging and insignificant findings (Fig 3). Since abdominal pain is a symptom for all the justified and most of the unjustified indications, a way to help referrers to distinguish differential diagnoses is urgently required.