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X‐rays had little value in diagnosing children’s abnormal skull shapes, and primary care clinicians should refer concerns to specialist teams
Author(s) -
O’Sullivan Hugh,
Bracken Shirley,
Doyle Jodie,
Twomey Eilish,
Murray Dylan J.,
Kyne Louise
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15686
Subject(s) - medicine , skull , referral , craniofacial , medical diagnosis , craniosynostosis , pediatrics , radiological weapon , primary care , retrospective cohort study , family medicine , surgery , radiology , psychiatry
Abstract Aim This study examined the consensus between the primary care radiological diagnosis and specialist clinical diagnosis of abnormal skull shapes in children. Methods We performed a retrospective review of children treated at the National Paediatric Craniofacial Centre at Children's Health Ireland, Dublin, Ireland. Group 1 were referred by primary care colleagues concerned about suspected abnormal skull shapes from 1 January 2015 to 30 May 2017. These included cases where they sought specialist confirmation that the skull shape was normal. Group 2 underwent surgery for craniosynostosis from 1 January 2011 to 25 October 2017. The primary care skull X‐ray reports were examined for both groups to see whether they matched the specialist diagnosis. Results Group 1 comprised 300 children, and 59 (20%) had pre‐referral skull X‐rays. The primary care X‐ray reports and specialist diagnoses agreed in 44 (75%) cases, including 19 (43%) who had a normal skull shape. Group 2 comprised 274 children, and 63 (23%) had pre‐referral skull X‐rays. In this group, there was agreement in 41 (65%) diagnoses; however, the primary care X‐ray reports did not diagnose craniosynostosis for the remaining 22 (35%) children. Conclusion X‐rays were of little value in diagnosing abnormal skull shapes, especially craniosynostosis, and primary care clinicians should refer concerns to specialist teams.