08-27-2020, 11:17 AM
I don’t think I’ll be able to offer a satisfactory explanation because that sounds like poor work, but I’ll try.
As far as missed injuries:
Xrays aren’t recommended for rib fractures in most cases because 50% of simple rib fractures are missed by X-rays. And even if you see the rib fracture the treatment is the same; pain management. If your mother in law is 70, I probably would have ordered the xrays or a CT. Over age 65 it is recommended they be admitted for pain management and respiratory therapy to reduce the chance of developing pneumonia. Imaging is more geared toward other underlying injuries, like pneumothorax or free air in the abdomen from a rib fracture puncturing other structures.
Compression fracture of T10 could be missed on X-ray and could also be pre-existing. Additional testing such as CT, MRI, or bone scan can help determine if the compression fracture is new or old. Usually the radiologist will advise you on additional testing in his report. The treatment would be pain management, again, with ortho referral. Surgery for a T10 compression fracture would be cases by case, but probably unlikely. Just let it heal.
A liver hematoma may not be present initially, but could develop over the next few days. I’ve seen cases like that monitored on an outpatient basis and they healed on their own.
As to why she wasn’t admitted, I don’t know. They may not have had the beds. If they didn’t have a bed, but thought she needed to be admitted then they should have arranged a transfer.
It’s difficult to speculate knowing so little.
As far as missed injuries:
Xrays aren’t recommended for rib fractures in most cases because 50% of simple rib fractures are missed by X-rays. And even if you see the rib fracture the treatment is the same; pain management. If your mother in law is 70, I probably would have ordered the xrays or a CT. Over age 65 it is recommended they be admitted for pain management and respiratory therapy to reduce the chance of developing pneumonia. Imaging is more geared toward other underlying injuries, like pneumothorax or free air in the abdomen from a rib fracture puncturing other structures.
Compression fracture of T10 could be missed on X-ray and could also be pre-existing. Additional testing such as CT, MRI, or bone scan can help determine if the compression fracture is new or old. Usually the radiologist will advise you on additional testing in his report. The treatment would be pain management, again, with ortho referral. Surgery for a T10 compression fracture would be cases by case, but probably unlikely. Just let it heal.
A liver hematoma may not be present initially, but could develop over the next few days. I’ve seen cases like that monitored on an outpatient basis and they healed on their own.
As to why she wasn’t admitted, I don’t know. They may not have had the beds. If they didn’t have a bed, but thought she needed to be admitted then they should have arranged a transfer.
It’s difficult to speculate knowing so little.
