Towards evidence based medicine for paediatricians. Arch Dis

Is ultrasound scanning as sensitive as CT in detecting skull fractures in children presenting following head injury? SCENARIO An 11-month-old child is brought to the emergency department following a witnessed fall from a dining room chair. There was no loss of consciousness and only a single episode of vomiting immediately following the fall. Neurological examination is normal, however, there is a 5 cm bruised boggy swelling in the left parietal region and you suspect there may be a skull frac-ture. The child meets the criteria for neuroimaging with CT scanning according to NICE guidance.1 The parents express anxiety about radiation exposure (a young relative is currently being treated for leukaemia), in addition to concerns about the need for sedation. The parents ask you about possible alterna