Original Investigation

Initial Imaging for Adults With Maxillofacial Trauma in a National Claims Database

JAMA Network Open 10.1001/jamanetworkopen.2025.58293

February 17, 2026 at 11:00 AM EST

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What are the prevalence and impact of low-value plain radiography use for initial imaging in adults with maxillofacial trauma?In this cohort study of 281 421 patients with maxillofacial trauma, 26% received low-value plain radiography as their initial imaging despite guideline recommendations favoring computed tomography (CT). Among patients receiving plain radiography, 6% required follow-up CT and 8% experienced delayed fracture diagnosis.Despite guideline recommendations favoring CT, low-value plain radiography remained common in facial trauma evaluation, highlighting opportunities to improve adherence to evidence-based imaging practices.

Corresponding Author: Kevin C. Chung, MD, MS, Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, 1500 E Medical Center Dr, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-5340 (kecchung@med.umich.edu).

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