The Role of Abdominal Radiography in the Diagnosis of Intussusception When Interpreted by Pediatric Emergency Physicians

Objective To evaluate the sensitivity and specificity of abdominal x-rays in the diagnosis of intussusception when interpreted by pediatric emergency physicians. Study design This was a prospective experimental study. Participants were board-certified/eligible pediatric emergency physicians. They evaluated a module containing radiographs of 50 cases of intussusception and 50 controls, matched for age and sex. For each x-ray, the physicians stated whether the x-ray increased, decreased or did not affect suspicion of intussusception. The primary outcome was the percentage of cases for which physicians stated that the x-ray increased their level of suspicion (sensitivity). Secondary outcomes included the proportion of false-negative results and specificity. Results Fourteen of 15 eligible physicians participated in the study. Overall, abdominal radiography increased the index of suspicion of intussusception in 48% of cases (sensitivity) and 21% of controls; however, in 11% of cases, the abdominal x-rays were incorrectly interpreted as being reassuring. The specificity was 21%. The radiographs were deemed equivocal for 41% of cases and 58% of controls. Conclusions Abdominal x-rays have a low sensitivity and specificity for diagnosing intussusception when interpreted by pediatric emergency physicians. (J Pediatr 2009; 155:556-9).