Is chest X‐ray still relevant for acute chest syndrome diagnosis?

• Published in: Health science reports 2024-05, Vol.7 (5), p.e2053-n/a
• Main Authors: Pelinski, Yanis, Guindo, Aldiouma, Kassasseya, Christian, Diallo, Dapa, Arlet, Jean‐Benoît, Dessap, Armand Mekontso, Habibi, Anoosha, Bartolucci, Pablo
• Format: Article
• Language: English
• Subjects: acute chest syndrome; Algorithms; Auscultation; Cardiology; chest X‐ray; Conflicts of interest; Dermatology; Emergency Medicine; Epidemiology; General Medicine; Genetics and Genomics; Hematology; Hospitalization; Medical diagnosis; Medical Education; Paediatrics and Adolescent Medicine; Pain; Patients; Pulmonary arteries; Radiation; Radiology & Imaging; Research Communication; Respiration; Sickle cell disease; Thrombosis; Tomography; Ultrasonic imaging; Veins & arteries; Writing; X-rays
• ISSN: 2398-8835; 2398-8835
• DOI: 10.1002/hsr2.2053

While the benefits of radiological medical procedures far outweigh the radiation risks when these procedures are appropriately prescribed and performed, a substantial fraction of radiation imaging procedures is unjustified or does not provide a net clinical benefit. 1 From an ethical standing point, the prescription of any medical exam should be governed by four simple questions: what do we expect from the result, does it provide new information, will it change the therapeutic course of action, and does the expected benefit of the result outweigh any short-term or long-term adverse effects caused by the exam? [...]in the case of an obvious clinical diagnosis with a favorable evolution, the balance between X-ray, usually with little impact on treatment course, and the risks of repeated irradiation in SCD patients, who are frequently hospitalized, must also be considered. 6 To determine the major diagnostic tools for ACS, we analyzed the patient cohort of the PRESEV 1 study, a monocenter, prospective, observational study whose aim was to develop a predictive score for ACS during VOC in adult patients with SCD. 7 ACS was defined as the appearance of an auscultatory abnormality and/or chest pain, associated with an infiltrate on chest X-ray and/or chest CT, excluding atelectasis. [...]considering that hospitalizations for VOC are frequent and ACS is a recurrent condition, this algorithm could enhance ACS diagnosis while effectively reducing patient exposure to irradiation throughout their lifetime.