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Original Research

Open Access

The Role of Pain Scoring in Multi-detector Computed Tomography Indications in Pediatric Occult Fractures

  • Hüseyin Mutlu1
  • Ahmet Çağlar1
  • Ekrem Taha Sert1

1Aksaray University Medical School, Department of Emergency Medicine, Aksaray, Turkey

DOI: 10.22514/sv.2020.16.0020 Vol.16,Issue 1,June 2020 pp.153-158

Published: 30 June 2020

*Corresponding Author(s): Ahmet Çağlar E-mail:


Introduction: Computed tomography (CT) is used in emergency orthopedic trauma cases with suspicion of fracture that cannot be detected on X-ray. Also pain during examination in patients with fracture is important for clinicians. We aimed to investigate whether pain severity is indicative of multi-detector CT (MDCT). Methods: A total of 175 patients included in the study. Visual analogue scale (VAS) was used to evaluate pre-examination pain in all patients. The most painful and suitable region for palpation were determined, palpated and the patients were asked to re-score their pain. In this way, the local VAS score was determined. MDCT was performed in all patients with general VAS of > 5. MDCT results were compared with the VAS scores. Results: Fracture detection in MDCT was 61.1% in patients with general VAS score of ≥ 5. Of the 105 patients with the local VAS score of ≥ 7, 90 had fractures. In these patients, the sensitivity, specificity, positive predictive value and negative predictive value of MDCT for detecting fractures were 84.1%, 77.9%, 85.7% and 75.7%, respectively. Conclusion: We believe that MDCT should be performed for suspected fracture if pain severity is high in isolated extremity trauma cases without fracture detection on X-ray.


Multi-detector Computed tomography, Pediatric trauma, Pain, Visual analogue scale

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Hüseyin Mutlu,Ahmet Çağlar,Ekrem Taha Sert. The Role of Pain Scoring in Multi-detector Computed Tomography Indications in Pediatric Occult Fractures. Signa Vitae. 2020. 16(1);153-158.


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