Objectives: The purpose of this pilot study was to obtain an Australian perspective\non evaluating the utility of plain film radiography and computed tomography\n(CT) to rule out fish bone impaction in the upper aerodigestive\ntract in the emergency department (ED) setting. Methods: A retrospective\nmulticentre cohort study was conducted. A total of 73 patients met the inclusion\ncriteria. A subgroup of patients underwent CT. We studied the sensitivity\nand specificity of x-ray and CT along with other demographic variables to determine\nthe likelihood of true fish bone impaction. Results: Out of the 73 patients,\n28 patients had true bone impaction. The sensitivity for x-ray was\n42.9% and specificity was 73.3%. The sensitivity of CT was 87.5% and specificity\nwas 71.4%. We found a significant difference in the mean age of presentation\nfor true bone and false bone impaction, P = 0.02. Conclusion: Due to\nthe low sensitivity of x-ray we do not recommend the utilisation of plain film\nradiography to rule out bone impaction Advances in low dose radiation multidetector\nCT scanners may replace plain film radiography as a screening tool.
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