Choosing Wisely:

Avoid performing plain x-rays in instances of facial trauma.

Rationale and Comments: Evidence currently indicates that maxillofacial CT is available in most trauma centers and is the most sensitive method for detecting fractures in instances of facial trauma. Evidence also indicates that the use of plain x-rays does not improve quality of care, causes unnecessary radiation exposure, and leads to substantial increase in costs. Use of plain x-rays for diagnosis and treatment is helpful in instances of dental and/or isolated mandibular injury or trauma.
Sponsoring Organizations:
  • American Society of Plastic Surgeons
  • Sources:
  • Expert consensus
  • Disciplines:
  • Emergency medicine
  • References: • Sitzman TJ, et al. Clinical criteria for obtaining maxillofacial computed tomographic scans in trauma patients. Plast Reconstr Surg. 2011 Mar;127(3):1270ā€“8.
    • Stacey DH, Doyle JF, Mount DL, Snyder MC, Gutowski KA. Management of mandible fractures. Plast Reconstr Surg. 2006 Mar;117(3):48eā€“60e.

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