Plain abdomen radiographs: the right view?

Karkhanis et al.
European Journal of Emergency Medicine
ISSN: 0969-9546 • Frequency:6/year • Subscribe Now

Special Introduction from the Authors

Plain abdomen radiographs (PAR) is an often utilized investigation in the emergency setting. With the advent of newer, more sensitive and specific investigations like Ultrasonography and Computed Tomography, the indications for PAR are slowly falling. Towards the same, the Royal College of Radiologists (RCR) published their guidelines- "Making the best use of a department of clinical radiology- Guidelines for Doctors, Fifth edition", 2003, outlining specific indications for use of PAR. These guidelines are regularly updated for the benefit of clinicians utilising them.

As a trainee working in the emergency department, with a keen interest in pursuing radiology as a career, it wasn't difficult to notice the non-compliance with these guidelines in our unit. It is needless to say that overuse of this investigation places a financial and radiation burden on the hospitals and patients respectively. The non- compliance is not due to lack of evidence, as is clear with the various published studies discussed in our study. Many of these, including this current study, have outlined different methods to ensure compliance with these guidelines. The different approaches vary from getting the basics of history-taking and clinical examination to implementing alternative investigations. However, as we realized from our study, the problem lay in adhering to these guidelines on a more personal level rather than an institutional or departmental level. It is the responsibility of individual practitioners to adhere to these guidelines for all the obvious reasons.

Through our study we intend to highlight many such aspects in ensuring compliance with RCR guidelines; some of which have been previously mentioned, while others have arisen from our own experience in the emergency department.

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