RATIONALE AND OBJECTIVES: @entity2688 is a common cause for @entity341 ( @entity341 ) presentation and subsequent hospital admission. Underlying @entity174 , @entity4034 , or foreign body is often considered in the clinical evaluation of these @entity1 . Accordingly, plain radiographs (XRs) of the affected extremity are often ordered during the initial work-up. The utility of these imaging studies in the treatment of uncomplicated @entity1746 , however, remains unclear. In an effort to treat this common problem more efficiently, we evaluated our imaging practices and results in a cohort of consecutive @entity1 admitted to a large public city hospital for treatment of uncomplicated @entity1746 . MATERIALS AND METHODS: Retrospective cohort study of 288 consecutive @entity341 admissions for treatment of uncomplicated @entity2688 , of which 214 met the inclusion criteria for this study. @entity1 demographics, history, vitals, laboratory values, and test results were evaluated with univariate and multivariate statistical analyses. RESULTS: XRs of the affected lower extremity were obtained in 158 @entity1 (73.8%). Positive XR findings were present in 19 @entity1 (12.0%) and positively correlated with a history of acute @entity130 to the extremity (P  <  .001) or the presence of a chronic wound (P  <  .01). Multivariable logistic regression analysis revealed a history of @entity130 (P  <  .001) or the presence of a chronic wound (P  <  .05) to be independent predictors of positive XR findings with relative risks of 6.24 and 2.98, respectively. CONCLUSIONS: The establishment of evidence-based guidelines for the treatment of @entity1746 has potential to significantly improve clinical efficiency and reduce cost by eliminating unnecessary testing. Based on our results, @entity1 without a recent history of @entity130 to the affected extremity or the presence of a chronic wound do not appear to warrant XRs. When applied to our cohort, only 48 of 158 @entity1 had a history of @entity130 or chronic wound. This means that 110 @entity1 unnecessarily had plain films taken as part of their initial work-up. In a largely uninsured inner city @entity1 population such as this cohort, that extra cost falls on the public hospital system.

Indications for Plain Radiographs  in  Uncomplicated Lower XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fracture'] @entity341 :: ('MESH:D004630', 'Disease') :: ['emergency department', 'ED'] @entity4034 :: ('MESH:D010019', 'Disease') :: ['osteomyelitis'] @entity2688 :: ('MESH:D002481', 'Disease') :: ['cellulitis', 'Cellulitis'] @entity1746 :: ('MESH:D020335', 'Disease') :: ['lower-extremity cellulitis'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity2688 :: (MESH:D002481,Disease) :: ['Extremity  Cellulitis']
