Authors (including presenting author) :
Ng WKC
Affiliation :
Department of Radiology, Princess Margaret Hospital
Introduction :
Scoliosis is a common problem in the paediatric population. Severe curvatures in immature spines need to be managed early by orthopedic surgeons, while mild cases in mature skeletons can be observed. Good radiographic technique with qualitied radiology reports can help non-orthopedic clinicians in the general outpatient to triage patients, facilitating more severe cases to be referred earlier for specialist attention while reducing unnecessary referrals of cases with minimal spinal listing. An audit was carried out at the Princess Margaret Hospital reviewing the reported paediatric scoliosis series over a two year period using the American College of Radiology guideline as the standard.
Objectives :
The objectives of this audit are to ensure the radiographic technique used and the adequacy of radiology reports are in accordance with the the ACR-SPR-SSR guidelie (American College of Radiology – Society of Paediatric Radiology – Society of Skeletal Radiology)
Methodology :
A total of 56 cases of pediatric (<18yro) scoliosis series identified in the period 14 June 2016 – 14 June 2018. Data was collected on the radiographic technique used and images analysed for their quality and sufficiency. The respective radiology reports were reviewed. Data on the inclusion of items as recommended by the ACR guideline was collected.and analysed Intervention measures to improve on the radiographic technique and radiology reporting based on findings in the first audit cycle included:
1) Establishing a new radiographic departmental protocol
2) Standardization of departmental template in the RIS (Radiology Information System)
3) Designating cases to be reported by the paediatric radiology team
4) Educational lecture 5) Provision of ‘cheat sheets’ on reporting stations A re-audit was performed on 21 paediatric scoliosis cases reported by the department from 14 June 2018 – 10 Jan 2019 after the recommended suggestions were implemented. The same parameters were analysed.
Result & Outcome :
In the first audit cycle, inadequacies were identified in the radiographic technique. 1) 97% of cases used AP rather than PA technique 2) 77% radiographs had inadequate inclusion of the pelvis. 70% of radiology reports did not comment on the presence/absence of osseous abnormalities. Only 5% had skeletal maturity reported. 50% did not measure Cobb angles while 35% employed the term ‘scoliosis’ in cases with Cobb angle <10 degrees. Significant improvement in compliance to the international guideline on both radiographic technique and reporting of scoliosis were seen in the second audit cycle. Conclusion:
Standardized, succint radiology reports can help clinicians refer more severe scoliosis cases for earlier specialist attention, and reassure the non-scoliosis cases with minimal spinal listin thus reducing their referrals to specialists clinics.
Co-location with:
