Accuracy of the sonographic fat pad sign for primary screening of pediatric elbow fractures: a preliminary study

Eckert, K.; Ackermann, O.; Janssen, N.; Schweiger, Bernd; Radeloff, E.; Liedgens, P.

doi:10.1007/s10396-014-0525-0

Cited by 24 publications

(6 citation statements)

References 40 publications

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“…As limitations, the authors mentioned that they had only one specialist that used ultrasound, suggesting that the diagnosis could be subjective. In contrast to other anatomical regions, the complete sonographic exam of the elbow is more sophisticated and requires a well-prepared specialist [35][36][37].…”

Section: Discussionmentioning

confidence: 99%

“…In a prospective study published by K. Eckert, O. Ackermann, N. Janssen et al in 2013, in which the accuracy of the US was followed in the diagnosis of posterior fat pad sign, as a predictor for the elbow fractures on pediatric patients, the authors found the following results: out of 79 children, 38 had elbow fractures. The sensitivity and specificity of the posterior fat pad sign diagnosed by US were 97.3% and 90.5%, respectively [37].…”

Section: Us Compared With X-ray In the Diagnosis Of Elbow Fractures (...mentioning

confidence: 97%

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Could Ultrasound Be Used as a Triage Tool in Diagnosing Fractures in Children? A Literature Review

et al. 2022

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Fracture is one of the most frequent causes of emergency department visits in children, conventional radiography being the standard imaging tool used for following procedures and treatment. This imagistic method is irradiating and harmful, especially for children due to their high cell division rate. For this reason, we searched the literature to see if musculoskeletal ultrasound is a good alternative for diagnostic and follow-up regarding fractures in the pediatric population. After searching the databases using MeSH terms and manual filters, 24 articles that compare X-ray and ultrasound regarding their specificity and sensitivity in diagnosing fractures were included in this study. In the majority of the studied articles, the specificity and sensitivity of ultrasound are around 90–100%, and with high PPVs (positive predictive values) and NPVs (negative predictive values). Although it cannot replace conventional radiography, it is a great complementary tool in fracture diagnosis, having a sensitivity of nearly 100% when combined with clinical suspicion of fracture, compared with X-ray.

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Section: Discussionmentioning

confidence: 99%

Section: Us Compared With X-ray In the Diagnosis Of Elbow Fractures (...mentioning

confidence: 97%

Could Ultrasound Be Used as a Triage Tool in Diagnosing Fractures in Children? A Literature Review

et al. 2022

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“…For supracondylar fractures of the distal humerus (SCFs) US diagnosis in comparison to radiography showed a sensitivity, specificity, NPV, and PPV of 100 %, 93.5 %, 100 %, 95.2 %, respectively [274]. The presence of the posterior/dorsal fat pad sign (dFPS) predicted an elbow fracture with a sensitivity and specificity just under 100 % and a PPV of 90.2 % with an NPV of 97.4 % [275,276]. Similar values of sensitivity and specificity were obtained in the detection of hand and foot bony fractures [277,278] A meta-analysis on occult ankle fractures in children with suspicious symptoms showed that the operating characteristic for US ranged in positive likelihood ratio from 9 to 20 and in negative likelihood ratio from 0.04 to 0.08 [279].…”

Section: Pediatric Traumamentioning

confidence: 99%

Section: Pediatric Applicationsmentioning

confidence: 99%

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures

et al. 2021

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The second part of the Guidelines and Recommendations for Musculoskeletal Ultrasound (MSUS), produced under the auspices of EFSUMB, following the same methodology as for Part 1, provides information and recommendations on the use of this imaging modality for joint pathology, pediatric applications, and musculoskeletal ultrasound-guided procedures. Clinical application, practical points, limitations, and artifacts are described and discussed for every joint or procedure. The document is intended to guide clinical users in their daily practice.

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“…A positive dorsal fat pad sign is seen as a correlate on radiography. Ultrasound has a sensitivity of 97-100 % and a specificity of 90 % here [21,22]. If a joint effusion is detected, radiography is indicated for fracture classification [16,17].…”

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confidence: 99%

Sonographic Fracture Diagnosis in Children and Adolescents

Moritz¹

2023

Rofo

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Background Clinical examination after trauma, especially in young children, often proves difficult. As a result, the majority of images show unremarkable findings in the imaging workup of trauma by radiography. Sonography represents an imaging technique without the use of X-rays. As the quality of ultrasound equipment has increased over the past 20 years, numerous studies have demonstrated that fractures in children and adolescents can be detected with very high sensitivity and specificity by sonography. Method This paper reviews the results obtained so far in the literature. Based on these findings, the importance of sonographic fracture diagnosis in childhood and adolescence for the most important locations is demonstrated. Results When examining with a high-frequency linear transducer, sensitivities and specificities of more than 90 % can be achieved for the detection of fractures. Dislocations are also reliably detected. In contrast to X-ray examination, sonography allows the diagnosis of cartilage and soft-tissue injuries. Sonography reveals callus formation earlier than radiographs. The examination causes less pain than X-ray examination. If sonographic clarification is limited purely to fracture detection or exclusion, less time is required compared to X-ray diagnosis. The procedure can be learned quickly. If the documentation follows a defined standard examination procedure, the results can also be reproduced by non-examiners. Conclusion So far, sonography has only been an additive procedure in fracture diagnosis. However, there are now initial recommendations for sonographic fracture diagnosis alone, such as in skull, clavicle and non-displaced distal forearm fractures. Key Points: Zitierweise

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Accuracy of the sonographic fat pad sign for primary screening of pediatric elbow fractures: a preliminary study

Cited by 24 publications

References 40 publications

Could Ultrasound Be Used as a Triage Tool in Diagnosing Fractures in Children? A Literature Review

Could Ultrasound Be Used as a Triage Tool in Diagnosing Fractures in Children? A Literature Review

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures

Sonographic Fracture Diagnosis in Children and Adolescents

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