Civil et al evaluated the need for pelvic radiography in patients after blunt trauma. They identified patients for whom radiographs are indicated for detection of occult trauma. The authors are from the UMDNJ-Robert Wood Johnson Medical School in New Jersey.


Indications for pelvic X-rays:

(1) The patient who is unconscious or impaired from CNS injury.

(2) The patient who is intoxicated with drugs and/or alcohol.

(3) The conscious and alert patient who has one or more signs and symptoms.


Signs and symptoms of pelvic fracture:

(1) pain in pelvic region

(2) swelling in groin and/or suprapubic region

(3) point tenderness over the pubis or iliac spine

(4) instability of the pelvis

(5) peripheral neuropathy

(6) pain, swelling, and ecchymosis of the medial thigh, genitalia, and lumbosacrum


The incidence of pelvic fracture in the unconscious or impaired patient was 14% in the series.


The risk of pelvic injury in the alert, conscious and asymptomatic patient is very low and X-rays are not indicated in this population.


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