Ultraschalldiagnostik von Rippen- und Sternumfrakturen

Bitschnau, R.; Gehmacher, O.; Kopf, Alfred W.; Scheier, M.; Mathis, Gebhard

doi:10.1055/s-2007-1000416

Cited by 75 publications

(19 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If fractures are subtle and non-displaced, standard radiography may appear to show normal findings, despite the presence of clinical symptoms and increased uptake on bone scintigraphy [8,18]. Sonography has been known to detect rib fractures with greater accuracy than conventional radiography, but it is operator dependent and is not practical for use in an emergency setting [7,9,10]. Recently, CT has been considered to be the first choice modality for evaluation of trauma patients, including ones with thoracic trauma [12].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT

Cho¹,

Sung²,

Kim³

2012

BJR

View full text Add to dashboard Cite

Objective: The objective of this study was to review the prevalence and radiological features of rib fractures missed on initial chest CT evaluation, and to examine the diagnostic value of additional coronal images in a large series of trauma patients. Methods: 130 patients who presented to an emergency room for blunt chest trauma underwent multidetector row CT of the thorax within the first hour during their stay, and had follow-up CT or bone scans as diagnostic gold standards. Images were evaluated on two separate occasions: once with axial images and once with both axial and coronal images. The detection rates of missed rib fractures were compared between readings using a non-parametric method of clustered data. In the cases of missed rib fractures, the shapes, locations and associated fractures were evaluated. Results: 58 rib fractures were missed with axial images only and 52 were missed with both axial and coronal images (p50.088). The most common shape of missed rib fractures was buckled (56.9%), and the anterior arc (55.2%) was most commonly involved. 21 (36.2%) missed rib fractures had combined fractures on the same ribs, and 38 (65.5%) were accompanied by fracture on neighbouring ribs. Conclusion: Missed rib fractures are not uncommon, and radiologists should be familiar with buckle fractures, which are frequently missed. Additional coronal imagescan be helpful in the diagnosis of rib fractures that are not seen on axial images.

show abstract

Section: Discussionmentioning

confidence: 99%

“…It has been noted that sonography reveals more fractures than radiography, but this modality depends on the operator's skill and is inaccessible to most emergency rooms [7,9,10]. Omert et al [11] reported that CT detected chest injuries in 39% of patients with an initial normal chest radiograph who were thought to have severe mechanism of injury.…”

mentioning

confidence: 99%

Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT

Cho¹,

Sung²,

Kim³

2012

BJR

View full text Add to dashboard Cite

show abstract

“…3), which appear as hypoechoic masses replacing the normal echogenicity of a rib and leading to the disruption of the cortical line [14]. Some evidence suggests that US may also be more sensitive than radiography in the detection of rib fractures [15], which appears as a breach or displacement of the rib cortex with or without a localized swelling or haematoma.…”

Section: Diagnostic Transthoracic Ultrasonographymentioning

confidence: 99%

“…Nevertheless, a recent meta-analysis concluded that bedside ultrasonography performed by clinicians had a higher sensitivity and similar specificity, when compared to chest radiography in the diagnosis of a pneumothorax [28]. A pneumothorax can be reliably diagnosed by means of the absence of normal lung sliding and lung pulse, exaggerated horizontal A-lines, the absence of B-lines and the presence of a lung point [1,2,4,15,28]. The ‘lung pulse’ refers to the subtle movements of the visceral pleura in relation to the parental pleura due to cardiac oscillations [4].…”

Section: Diagnostic Transthoracic Ultrasonographymentioning

confidence: 99%

Transthoracic Ultrasonography for the Respiratory Physician

Koegelenberg

Groote-Bidlingmaier²,

Bolliger³

2012

Respiration

133

View full text Add to dashboard Cite

Transthoracic ultrasonography is still not utilized to its full potential by respiratory physicians, despite being a well-established and validated imaging modality. It allows for an immediate and mobile assessment that can potentially augment the physical examination of the chest. Ultrasound (US)-assisted procedures can be performed by a single clinician with no sedation and with minimal monitoring, even outside of theatre. The main indications for the use of transthoracic US are: the qualitative and quantitative description of pleu-ral effusions, pleural thickening, diaphragmatic dysfunction and chest-wall and pleural tumours. It may also be used to visualise lung tumours and other parenchymal pulmonary processes provided they abut the pleura. It is at least as sensitive as chest radiographs as far as the detection of a pneumothorax is concerned. It is the ideal tool to assist with thoracocentesis and drainage of effusions. The US-assisted fine-needle aspiration and/or cutting-needle biopsy of extrathoracic lymph nodes, lesions arising from the chest wall, pleura, peripheral lung and mediastinum, are safe and have a high yield in the hands of chest physicians. US may also guide the aspiration and biopsy of diffuse pulmonary infiltrates, consolidations and lung abscesses, provided the chest wall is abutted. Advanced applications of transthoracic US include the diagnosis of pulmonary embolism.

show abstract

“…An einigen Lokalisationen, z. B. an der Klavikula und den Rippen, ist die Sonografie sensitiver als die Röntgendiagnostik [15,19]. Ähnlich wie anhand von Röntgenaufnahmen finden sich gelegentlich Probleme bei komplexen Frakturen, gelenknahen Frakturen, insbesondere nicht dislozierten epiphysären Frakturen, und Frakturen der kleinen tubulären Knochen an Hand und Fuß [14].…”

unclassified