TITLE:
The Utility of Diagnostic Imaging in Fish Bone Impaction
AUTHORS:
Shanesh Kumar, Casey Yu, Jason Toppi, Matthew Ng, Fiona Hill, Natalie Sist
KEYWORDS:
Fish Bone Impaction, Emergency, ENT, X-Ray, Computed Tomography
JOURNAL NAME:
Open Journal of Radiology,
Vol.8 No.1,
March
14,
2018
ABSTRACT: Objectives: The purpose of this pilot study was to obtain an Australian perspective on evaluating the utility of plain film radiography and computed tomography (CT) to rule out fish bone impaction in the upper aerodigestive tract in the emergency department (ED) setting. Methods: A retrospective multicentre cohort study was conducted. A total of 73 patients met the inclusion criteria. A subgroup of patients underwent CT. We studied the sensitivity and specificity of x-ray and CT along with other demographic variables to determine the likelihood of true fish bone impaction. Results: Out of the 73 patients, 28 patients had true bone impaction. The sensitivity for x-ray was 42.9% and specificity was 73.3%. The sensitivity of CT was 87.5% and specificity was 71.4%. We found a significant difference in the mean age of presentation for true bone and false bone impaction, P = 0.02. Conclusion: Due to the low sensitivity of x-ray we do not recommend the utilisation of plain film radiography to rule out bone impaction Advances in low dose radiation multidetector CT scanners may replace plain film radiography as a screening tool.