Current Role for Ultrasonography

The role of ultrasound as a problem-solving tool in the assessment of paediatric musculoskeletal injuries

“…A radiograph may be reported as normal if the diagnosis of avulsion injury is not considered as radiographic findings in acute injury can be very subtle. 14,16 Lazovic et al. 17 proved in a large series of patients with suspected apophyseal injuries that US was more sensitive than plain radiographs with the added advantage that dynamic examinations can identify unstable avulsion injuries.…”

“…US can demonstrate haematoma at the injured site, irregularity within the bone, increased distance to the apophysis, dislocation of the apophysis and early neovascularisation increasing diagnostic accuracy. 14,16,17 This is especially helpful if injury occurs at unusual sites and in younger patients unable to communicate and localise their symptoms well, or in whom the apophysis has not ossified (Figure 1). 8,17 In our practice, it also has an important role in cases where presentation has been delayed or where symptoms persist and can be shown to be due to tendinopathy or failure of the avulsion fracture to unite (Figure 2).…”

Ultrasound of the Upper Limb: When to Use It in Athletes

“…Increasingly, it is being used early in the diagnostic process for upper limb injuries. [4][5][6][7] But it is not useful for examining deep structures within joints or articular surfaces. It cannot be used to detect oedema or microfracturing within bone, and it is unreliable when dis-ease does not affect the surface of the bone.…”