The prevalence of traumatic brain injury (TBI) on CT in children with head injury presenting > 24 hours post-injury was 3.8%. Predictors on TBI on CT were suspicion of depressed skull fracture and non-frontal scalp hematoma.
In this systematic review and meta-analysis, no single aspect of the physical examination, imaging, or LRINEC score had high enough sensitivity to exclude necrotizing soft tissue infections. Contrast CT performed the best, but it was only 94.3% sensitive at best. If you have a high clinical suspicion, early surgical consultation is necessary for definitive diagnosis and management.
In this retrospective review, age-adjusted, clinical probability-adjusted, and standard D-dimer approaches had similar NPVs (99.7%, 99.1%, 100% respectively). Clinical probability-adjusted D-dimer has potential to exclude PE in more patients without imaging, but use caution before applying this to practice until prospectively validated.