Despite Guidelines Recommending CT, Plain Radiography Is Common in Facial Trauma Evaluation

Background: Because maxillofacial trauma can result in subtle but significant injuries in patients, both the American College of Radiology (ACR) and the American Society of Plastic Surgeons (ASPS) recommend initial CT imaging and not the use of initial plain x-ray imaging for this clinical scenario. However, such x-ray imaging is still performed despite their low value to assess the injuries from maxillofacial trauma. Objective: To evaluate use of plain x-ray imaging versus CT imaging for the initial evaluation of patients with maxillofacial trauma. Design: Retrospective study. Methods: The authors obtained imaging data on patients who had experienced maxillofacial trauma from the Merative MarketScan Commercial Claims and Encounters Database from January 2013 to December 2022. The pertinent imaging data were obtained using the ICD-9/10 codes for the examinations performed on patients who had undergone maxillofacial trauma within 7 days prior. The high-value imaging examinations were more...