ORIGINAL ARTICLE   

Journal of Radiological Review 2021 December;8(4):275-82

DOI: 10.23736/S2723-9284.21.00089-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Post-traumatic incidental findings at spine X-ray: prevalence, classification and management

Francesco RIPANDELLI ¹ ✉, Giulio GAMBARACCI ², Lucio BELLANTONIO ³, Eugenio BELATTI ¹, Ewa Barbara SIELASZUK ¹, Francesca BANELLI ¹, Anna CIPICIANI ¹, Ernesto PIANE ¹, Pasquale RUSSO ¹, Alessandra ARNONE ¹, Beatrice VIGNA ¹, Alessandro BELLINI ¹, Andrea BIAGELLI ¹, Andrea FERRARO ¹, Giovanni Battista SCALERA ¹, Michele SCIALPI ¹

¹ Division of Diagnostic Imaging, Department of Medicine and Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy; ² Unit of Radiodiagnostic, Assisi Hospital, USL Umbria 1, Assisi, Italy; ³ Unit of Neuroradiology, S. Maria della Misericordia Hospital, Perugia, Italy

BACKGROUND: The aim of the study was to assess the prevalence and the clinical relevance of incidental findings (IF), detected during spine X-ray after trauma.
METHODS: We performed a retrospective analysis of spine X-ray after trauma of 785 patients (females N.=438, males N.=347, age range 18-102 years, mean age 50 years), to detect IF and to verify if these findings were included in the radiology report. In line with the clinical relevance, according to a modified CT Colonography Reporting and Data System (C-RADS), IF were divided into three categories: 1) major (occasional potentially serious finding for which further investigation is always necessary); 2) moderate (further investigation or follow-up depends on the symptomatology of the patient); and 3) minor (no specific follow-up with unlikely harmful effect on health).
RESULTS: IF were found in 353 patients (45%) for a total of 521 IF (cervical spine N.=198, thoracic N.=85, lumbo-sacral N.=238). The majority of IF was recorded during afternoon shift (from 1 pm to 9 pm). The biggest difference between observed and unnoticed IF on the formal radiology report, has been found during the same working hours. The majority of IF (468/521, 89.83%) were scored as minor, 48/521 (9.21%) as moderate and 5/521 (0.96%) as major.
CONCLUSIONS: The majority of IF was not clinically relevant; however, in a low percentage of cases, significant IF were identified, worthy of dedicated management. The majority of unreported IF has been recorded during the afternoon shift due to the heavy workload, and not during the night shift, as previously supposed. A proper attention is required from radiologists, in order to detect IF, which deserve further investigations.

KEY WORDS: Incidental Findings; X-ray; Spine; Trauma