A study of the utilisation of skull radiography in 9 accident-and-emergency units in the U.K. A national study by the Royal College of Radiologists
Lancet 2(8206): 1234-1236
1980
ISSN/ISBN: 0140-6736 PMID: 6108403 Document Number: 167166
Over a period of ten weeks, nine accident-and-emergency units in England, Wales, and Scotland took part in an investigation into the use of skull radiography in the management of patients with head injury. 118 patients (2.0%) with linear fracture and 4 (0.07%) with depressed fracture were recorded in 5850 patients radiographed. Although only 1018 (17.4%) of these patients with head injury had significant additional injuries or pathology, they contributed just under half of the skull fractures detected. 90% of all requests for skull radiography were made by recently qualified doctors who, before radiography, classified 25.9% of their referrals as "fracture definitely absent". They were 99% accurate in this prediction. Traumatic intracranial haematoma and intracranial aerocele, conditions which the discovery of a skull fracture can help to anticipate, were recorded in 12.0 and 1.7 per 10,000 patients radiographed respectively.