The increased use of computed tomography scanning for diagnosing superficial soft tissue infections: a disturbing trend of increased radiation with no benefit

BackgroundSoft tissue infections have historically been diagnosed on the basis of clinical signs and symptoms. A trend toward the increased use of computed tomographic (CT) imaging in their evaluation has been noted.MethodsA retrospective review was performed of soft tissue infection admissions in 2003 and 2004 and in 2009 and 2010. Intracavitary abscesses (eg, intra-abdominal, pelvic) that would not be evident on physical examination were excluded. Demographic and outcome variables, number of CT scans by body region, and total effective radiation dose were recorded. Radiation exposure was stratified into low, moderate, high, and very high categories.ResultsThere was a significant increase in the number of patients receiving ≥1 CT scan for initial diagnosis, from 36.7% in the early cohort to 50% in the later cohort (P < .001). The mean cumulative effective dose increased from 5.46 to 7.82 mSv (P = .007). Greater proportions of patients fell into the moderate (32.9% vs 24.5%) and high (6.8% vs 10.6%) radiation exposure categories.ConclusionsCT scans are increasingly used in the evaluation of soft tissue infections, with resultant increase in radiation exposure.