Most Missed Cases: Sacral Fracture

Follow along as our expert subspecialist reviews this case of sacral fracture as demonstrated on a radiography study. Sacral fractures can be hard to identify on radiographs and computed tomography is recommended to better characterize whether the sacral fracture involves the foramina or spinal canal and to further assess for pelvic ring injury. Severe cases of sacral fracture may require surgery when the nerves that control the bladder, bowel, or legs are affected.

Over the last 10 years, the Department of Radiology at the University of Florida College of Medicine has conducted a simulation-based evaluation of radiology resident competence in critical care imaging.

321 residents interpreted this case of sacral fracture as one of 65 cases during an 8-hour simulated on-call shift, with a median score of 0 out of 10 and an overall average score of 1.29 out of 10.

On average, 8.71 points out of 10 were lost due to missed observations. At the same time, 0.00 points were lost due to interpretive errors.

We define an effective report to be one which achieves scores between 7 and 10. In terms of letter grades, this would be A & B. In this “most missed” case 6% of residents produced effective reports.

We define a report having a critical error to be one with scores between 0 and 2. In terms of letter grades, this would be F & D. In this “most missed” case 80% of residents produced reports with critical error(s).

View the full DICOM set and final report here: https://bit.ly/3NZRv4f

Claim 0.5 AMA PRA Category 1 CME Credit™ per case by reviewing this case and others available in our Decision Support critical care case library. Use WIDIonline to fill in your knowledge gaps by reviewing our educational curriculum on this subject.

WIDI Online: https://widionline.xray.ufl.edu/
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WIDI SIM is a critical care radiology SIMulation consisting of 65 cases across all subspecialties and modalities, including normals, given over an eight hour “shift” experience.

For more information on WIDI SIM: https://widi.xray.ufl.edu/widi-research/publications/

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Intro 0:00
Case Statistics 0:14
Missed Case: Sacral Fracture 1:02
Teaching Points 2:40

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