Plain films are commonly used to screen children for pelvic fractures or dislocations following blunt torso trauma
The sensitivity of this common screening practice is unknown
A recent study looked at this question.
Of 451 patients with pelvic fractures or dislocations, 382 had AP radiographs. Injury was correctly identified in 297 patients (sensitivity 78%).
The sensitivity was greater in the sicker subgroups :92% for those requiring operative intervention and 82% for those with hypotension
Plain AP pelvic radiographs should have a limited role in the sole evaluation of children with blunt torso trauma.
They should be incorporated in the assessment of hemodynamically unstable children and those in whom the clinician is not planning on otherwise obtaining an abdominal/pelvis CT.
