Comparison of diagnostic accuracy of bedside ultrasonography and radiography for calcaneal fractures in the emergency department

Abstract

Objective: Ultrasonography (US) is not the method of choice for the diagnosis of calcaneal fractures. The aim of this study was to compare the diagnostic accuracy of US with plain radiography in the diagnosis of calcaneus fractures following blunt ankle and foot trauma. Methods: In this cross-sectional study, 214 patients (over 18 years) presenting to the emergency department (ED) with suspicion of traumatic calcaneus fracture following acute blunt trauma, were enrolled. Bedside ultrasonography was performed and interpreted by emergency physicians. After that, plain radiography was performed. Furthermore, all the patients were assessed by computed tomography (CT) scan as the gold standard. Results: Finally, 193 patients were enrolled with a mean age of 29.4 ± 15.7 years (85.5% male). Fractures in the calcaneus were detected in 49 patients. The sensitivity and specificity of ultrasonography in the detection of calcaneal fractures were 83.6%, (confidence interval (CI), 69.7-92.2) and 100% (95% CI, 96.7-100), while the sensitivity and specificity of X-ray were 87.7% (95% CI, 74.5-94.9) and 100% (95% CI, 96.7-100). There was no false positive result for X-ray and US. Conclusion: Our findings suggest that bedside US with an acceptable sensitivity and specificity can be used as a promising alternative for the diagnosis of calcaneal fracture in ED.

The Predictive Value of Point-of-care Ultrasonography versus MRI in Assessing Medial Meniscal Tears in Patients with Acute Knee Injury

“…Recently, bedside ultrasonography (US) has been increasingly performed to investigate patients with suspected soft tissue or bone injuries due to its accuracy and diagnostic value in ED settings [ 10 , 11 ]. Since knee structures are superficial, they are easily and quickly assessed with US [ 2 , 12 , 13 ], which is a noninvasive, inexpensive, dynamic, readily available, and real-time modality [ 14 , 15 ].…”

“…US has been used to diagnose knee meniscal tears for over two decades [ 2 , 14 , 16 ]. Point-of-care US (POCUS) can be used efficiently and without being time-consuming in ED settings, especially in patients with trauma [ 2 , 10 ].…”

Role of point-of-care ultrasonography (POCUS) in the diagnosing of acute medial meniscus injury of knee joint

“…In addition, in recent years, ultrasonography (US) for evaluating patients with suspicious soft tissue or bone injuries has become increasingly recognized for its diagnostic value in the ED setting due to its accuracy [8]. The structures of the ankle are superficial and can be easily evaluated by the US [7,8].…”

“…In addition, in recent years, ultrasonography (US) for evaluating patients with suspicious soft tissue or bone injuries has become increasingly recognized for its diagnostic value in the ED setting due to its accuracy [8]. The structures of the ankle are superficial and can be easily evaluated by the US [7,8]. Point-of-care ultrasound (POCUS) is an alternative, inexpensive, non-invasive, easily available, and real-time imaging tool to identify the soft tissue pathology of the knee, including medial meniscus injuries [9,10].…”

“…The US examination is a possible alternative to MRI, and it can be done faster and cheaper to evaluate meniscus. The use of POCUS for diagnosing meniscal tears has been proposed, but the diagnostic accuracy of ultrasound for knee meniscus injuries has remained controversial [1,5,8]. The sensitivity and specificity of US in the diagnosis of meniscus injuries have indicated a wide range in previous studies [12][13][14][15].…”