Abstract:
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Purpose: To compare the sensitivity of ultrasound and x-ray in the diagnosis of fractures in children and to decide, to what extent ultrasound enables a focused x-ray of fractures.
Methods and Materials: Altogether 486 children referred for diagnosis or exclusion of a fracture were examined with ultrasound as well as with x-ray (skull 90, clavicle 37, upper arm 71, lower arm 98, hand 22, upper limb 45, lower limb 77, foot 33, thorax 12). Age ranged from 1 month to 17 years.
Results: 277 fractures were identified, 210 by ultrasound and 214 by x-ray. One case of fracture of the middle face was detected only by CT. False positive results were seen in two cases with ultrasound, in one case with x-ray. In 12 cases of normal x-rays the fracture was identified by ultrasound. Ultrasound had a sensitivity of 92.5% and x-ray of 94.3% for detection of a fracture. The specificity was 99.2% for ultrasound and 99.6% for x-ray. Additional information were obtained in 14 cases by ultrasound and in 5 cases by x-ray.
Conclusion: Fractures were diagnosed by ultrasound as sensitively as by x-ray. Therefore all children with trauma and without clinically exact localization of pain should be examined primarily by ultrasound followed by a focused x-ray. The number of x-rays with negative findings as well as the total radiation dose could be reduced significantly.
Questions about this event email: joerg.d.moritz@radiol.med.uni-giessen.de
Moritz MD, J,
Ultrasound in Diagnosis of Fractures in Children: Unnecessary Harassment or Useful Addition to x-ray?. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3102709.html
