Comparative radio-opacity of bones of commonly consumed fish species in western Kenya region on digitalised lateral neck X-ray films

Abstract

Objective: To determine the comparative radio-opacity on digital plain radiographs of bones of 10 fish species commonly consumed in Western Kenya Region.

Design: Descriptive cross sectional study.

Setting: Jaramogi Oginga Teaching and Referral Hospital, Kisumu Kenya.

Results: There was excellent interobserver agreement on the rating of 21out of 25 films evaluated. The overall sensitivity of plain radiographs in detection of raw and cooked fish bones was 72% and 69% respectively but varied significantly between fish species. The specificity of the technique was 100% overall.

Conclusion: Lateral soft tissue neck radiograph is an appropriate screening tool in cases of a suspected impacted fishbone. If a fishbone is identified on a radiograph, the patient should be referred for endoscopy without further imaging. If the radiograph is normal, then there should be no further imaging or endoscopy. An observation policy can be adopted. Radiographs may be of limited value in cases of Butter fish (Schilbe intermedius) and Elephant snout fish (Momuruscarnume) bone impaction as these bones are radiolucent. In such cases, further imaging by CT scan or endoscopy without further imaging may be recommended when clinically indicated.