Do not waste your time

straight to magnetic resonance imaging for pediatric burners and stingers

Richard Sola, A. Britton Christmas, Bradley W. Thomas, Peter Fischer, Grayson C. Eubanks, Nora E. Raynor, Ronald F. Sing

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Permanent neurologic injury in pediatric patients with burner and stinger syndrome (BSS) is unlikely. This study aims to assess the feasibility of clinical observation without extensive radiologic workup in this selective population. Methods A retrospective study was conducted of patients aged younger than 18 years evaluated at a level I trauma center from 2012 to 2014. Patients were grouped according to positive deficit (PD) or negative deficit (ND) upon physical examination. Demographics, clinical findings, and outcomes were analyzed. Results Thirty patients (ND, n = 14; PD, n = 16) were evaluated for BSS, most often as a result of injurious football tackle. Age and length of stay were similar between groups. Injury Severity Score was lower in the ND group than the PD group (1.6 ± 1.2 vs 3.8 ± 3.1, respectively; P<.05). Cervical computed tomography was performed on 11 patients (78.6%) in the ND group and 15 patients (93.8%) in the PD group at considerable added cost, with only 1 positive result in the ND group and none in the PD group. Magnetic resonance imaging (MRI) revealed 2 positive findings in each group, and no surgical interventions were indicated. Ten ND (71.4%) and 12 PD (75%) patients reported complete resolution of symptoms at discharge (P>.05). Conclusions Children presenting with BSS experience temporary symptoms that resolve without surgical intervention. Magnetic resonance imaging identified more injuries than computed tomographic imaging; therefore, we suggest that management for BSS should include observation, serial neurologic examinations, and MRI evaluation as appropriate.

Original languageEnglish (US)
Pages (from-to)1442-1445
Number of pages4
JournalAmerican Journal of Emergency Medicine
Volume34
Issue number8
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

Fingerprint

Magnetic Resonance Imaging
Pediatrics
Observation
Nervous System Trauma
Injury Severity Score
Football
Trauma Centers
Neurologic Examination
Physical Examination
Length of Stay
Retrospective Studies
Demography
Wounds and Injuries
Population

All Science Journal Classification (ASJC) codes

  • Emergency Medicine

Cite this

Do not waste your time : straight to magnetic resonance imaging for pediatric burners and stingers. / Sola, Richard; Christmas, A. Britton; Thomas, Bradley W.; Fischer, Peter; Eubanks, Grayson C.; Raynor, Nora E.; Sing, Ronald F.

In: American Journal of Emergency Medicine, Vol. 34, No. 8, 01.08.2016, p. 1442-1445.

Research output: Contribution to journalArticle

Sola, Richard ; Christmas, A. Britton ; Thomas, Bradley W. ; Fischer, Peter ; Eubanks, Grayson C. ; Raynor, Nora E. ; Sing, Ronald F. / Do not waste your time : straight to magnetic resonance imaging for pediatric burners and stingers. In: American Journal of Emergency Medicine. 2016 ; Vol. 34, No. 8. pp. 1442-1445.
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abstract = "Background Permanent neurologic injury in pediatric patients with burner and stinger syndrome (BSS) is unlikely. This study aims to assess the feasibility of clinical observation without extensive radiologic workup in this selective population. Methods A retrospective study was conducted of patients aged younger than 18 years evaluated at a level I trauma center from 2012 to 2014. Patients were grouped according to positive deficit (PD) or negative deficit (ND) upon physical examination. Demographics, clinical findings, and outcomes were analyzed. Results Thirty patients (ND, n = 14; PD, n = 16) were evaluated for BSS, most often as a result of injurious football tackle. Age and length of stay were similar between groups. Injury Severity Score was lower in the ND group than the PD group (1.6 ± 1.2 vs 3.8 ± 3.1, respectively; P<.05). Cervical computed tomography was performed on 11 patients (78.6{\%}) in the ND group and 15 patients (93.8{\%}) in the PD group at considerable added cost, with only 1 positive result in the ND group and none in the PD group. Magnetic resonance imaging (MRI) revealed 2 positive findings in each group, and no surgical interventions were indicated. Ten ND (71.4{\%}) and 12 PD (75{\%}) patients reported complete resolution of symptoms at discharge (P>.05). Conclusions Children presenting with BSS experience temporary symptoms that resolve without surgical intervention. Magnetic resonance imaging identified more injuries than computed tomographic imaging; therefore, we suggest that management for BSS should include observation, serial neurologic examinations, and MRI evaluation as appropriate.",
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AB - Background Permanent neurologic injury in pediatric patients with burner and stinger syndrome (BSS) is unlikely. This study aims to assess the feasibility of clinical observation without extensive radiologic workup in this selective population. Methods A retrospective study was conducted of patients aged younger than 18 years evaluated at a level I trauma center from 2012 to 2014. Patients were grouped according to positive deficit (PD) or negative deficit (ND) upon physical examination. Demographics, clinical findings, and outcomes were analyzed. Results Thirty patients (ND, n = 14; PD, n = 16) were evaluated for BSS, most often as a result of injurious football tackle. Age and length of stay were similar between groups. Injury Severity Score was lower in the ND group than the PD group (1.6 ± 1.2 vs 3.8 ± 3.1, respectively; P<.05). Cervical computed tomography was performed on 11 patients (78.6%) in the ND group and 15 patients (93.8%) in the PD group at considerable added cost, with only 1 positive result in the ND group and none in the PD group. Magnetic resonance imaging (MRI) revealed 2 positive findings in each group, and no surgical interventions were indicated. Ten ND (71.4%) and 12 PD (75%) patients reported complete resolution of symptoms at discharge (P>.05). Conclusions Children presenting with BSS experience temporary symptoms that resolve without surgical intervention. Magnetic resonance imaging identified more injuries than computed tomographic imaging; therefore, we suggest that management for BSS should include observation, serial neurologic examinations, and MRI evaluation as appropriate.

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