Journal of pediatric surgery · 2019
Resource overutilization in the diagnosis of lymphedema praecox.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shah Adil A, Petrosyan Mikael, Nizam Wasay, Roberson Jeffrey, Guzzetta Philip
Аннотация
PURPOSE: Primary lymphedema presenting in adolescence is known as lymphedema praecox. Older children presenting with leg swelling are often subjected to a myriad of diagnostic tests. The purpose of this study is to review a large-cohort of patients with lymphedema praecox to determine the fiscal impact of diagnostic testing on these patients.
METHODS: A 13-year review was performed of patients with lymphedema praecox. Information was obtained on demographic parameters, diagnostic studies performed, and clinical outcomes.
RESULTS: Forty-nine patients were identified. The median age was 14 (range: 7-21) years. Participants were predominantly female (n = 40, 81.6%). 19 patients had bilateral disease and 30 had unilateral disease. The diagnosis was made on clinical exam only in 14 patients. 35 patients had imaging which consisted of plain X rays, Doppler ultrasound (DUS), lymphoscintigraphy (LSG) or MRI as the sole imaging study (n = 28) or in combination with others (n = 7). The charges for plain X-rays, DUS, LSG, and MRI with contrast were $335, $1715, $1269, and $6006 respectively.
CONCLUSION: We believe that in the adolescent female with physical findings consistent with lymphedema praecox, diagnostic imaging should be limited to a Doppler ultrasound to rule out a secondary cause of the swelling.
LEVEL OF EVIDENCE: IV TYPE OF EVIDENCE: Case series with no comparison group.
METHODS: A 13-year review was performed of patients with lymphedema praecox. Information was obtained on demographic parameters, diagnostic studies performed, and clinical outcomes.
RESULTS: Forty-nine patients were identified. The median age was 14 (range: 7-21) years. Participants were predominantly female (n = 40, 81.6%). 19 patients had bilateral disease and 30 had unilateral disease. The diagnosis was made on clinical exam only in 14 patients. 35 patients had imaging which consisted of plain X rays, Doppler ultrasound (DUS), lymphoscintigraphy (LSG) or MRI as the sole imaging study (n = 28) or in combination with others (n = 7). The charges for plain X-rays, DUS, LSG, and MRI with contrast were $335, $1715, $1269, and $6006 respectively.
CONCLUSION: We believe that in the adolescent female with physical findings consistent with lymphedema praecox, diagnostic imaging should be limited to a Doppler ultrasound to rule out a secondary cause of the swelling.
LEVEL OF EVIDENCE: IV TYPE OF EVIDENCE: Case series with no comparison group.