Ultrasonography as a better diagnostic efficiency in rib fracture

Uzun, Metin; Beksaç, Burak; Kara, Adnan; Küçükdurmaz, Fatih; Tetik, Cihangir

doi:10.5835/jecm.omu.30.02.009

Cited by 4 publications

(2 citation statements)

References 20 publications

(37 reference statements)

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“…In a recent study, the sensitivity of ultrasound compared to radiography was estimated to be 98.31% (13). The sensitivity of ultrasound in the diagnosis of rib fractures was obtained about 92% in another report (19). In our study, the sensitivity of POCUS compared to CT scan was investigated, which was lower than the above values.…”

Section: Discussionmentioning

confidence: 54%

Diagnosis of Rib Fracture and Related Complications in Patients with Blunt Chest Wall Trauma Using Point-of-Care Ultrasound vs. Computed Tomography Scan

Zarei Jelyani,

Mousavi-Roknabadi,

Mohammadi

et al. 2023

Shiraz E-Med J

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Background: One of the most common reasons for the referrals of patients to the trauma center is blunt chest injury. Objectives: To determine and compare the diagnostic value of point-of-care ultrasound (POCUS) and computed tomography (CT) scans in detecting rib fractures and their complications in patients with blunt chest wall trauma. Methods: The current cross-sectional study (October 2017-March 2018) was conducted in Shahid Rajaei Hospital, Shiraz, southern Iran. Convenient non-random sampling was employed. Patients with stable vital signs underwent ultra-sonography and later were evaluated by computed tomography (CT) scan for fractures and related complications. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPP), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and accuracy were calculated and compared between the two procedures. Results: A total of 113 patients with a mean ± SD age of 44.07 ± 20.07 years were enrolled, of whom 75 (66.3%) and 62 (54.9%) patients had at least one broken rib based on CT scan and sonography, respectively. The frequency of double fractures was higher than other conditions in both CT scans and ultrasound (35.53% and 37.10%). The overall sensitivity of ultrasound was calculated to be 81.58%, and with an increasing number of broken ribs, the sensitivity of ultrasound also increased (73.08% for identifying patients with one damaged rib versus 100% for detecting patients with five or more broken ribs). None of the 13 definite cases of pneumothorax were detected on ultrasound, while the sensitivity of ultrasound was appropriate for hemothorax and subperiosteal hematoma (85.71% and 80.23%, respectively). Conclusions: Ultrasound offers high sensitivity, specificity, and diagnostic power in diagnosing fractures and their complications, but considering the setting of our study, care should be taken when generalizing the findings of this study.

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Section: Discussionmentioning

confidence: 54%

Diagnosis of Rib Fracture and Related Complications in Patients with Blunt Chest Wall Trauma Using Point-of-Care Ultrasound vs. Computed Tomography Scan

Zarei Jelyani,

Mousavi-Roknabadi,

Mohammadi

et al. 2023

Shiraz E-Med J

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“…Meanwhile, the US is an easy, accessible, rapid, and accurate diagnostic procedure in hemodynamically unstable patients with hemothorax and/or pneumothorax [1]. The diagnosis of rib fracture is also important in terms of the medico-legal perspective [2,16]. The significant ultrasonography disadvantages are the difficulty in diagnosis in large-breasted patients, obesity, fractures in the ribs under the scapula, or the first rib fractures below the clavicle [1,5,8].…”

Section: Discussionmentioning

confidence: 99%

Is ultrasonography helpful in minor trauma patients with rib fractures?

İsmailoğlu¹,

Akçay²

2020

Curr Thorac Surg

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Background: The most common injury associated with blunt thoracic trauma is the rib fracture. Outpatients, who had a minor blunt trauma that did not form any complications, present more than half of the rib fractures. Unfortunately, there are several limitations on the chest x-ray. In this study, we investigated the efficacy of ultrasonography in the diagnosis of rib fractures resulting from blunt thoracic trauma. Materials and Methods: Fifty-eight patients who were admitted to the Thoracic Surgery Outpatient Clinic in our center due to minor thoracic trauma between October 2017 and July 2018 were included in the study. All patients underwent chest radiography, and thorax US after a detailed history and physical examination were performed. Results: Of the 58 patients included in the study, 33 (56.9%) were male, and 25 (43.1%) were female, while the mean age was 46.79 ± 15.75 years. While the rib fractures were detected in 24 patients with chest x-ray, US detected rib fractures in 47 patients. The comparison between the two examinations, the superiority of the US in the diagnosis of rib fracture was statistically significant compared to the chest radiography (p < 0,001). Conclusions: We believe that preferring ultrasound instead of thorax CT for its less radiation and lower cost at the next step beyond chest x-ray for patients, who applied to the outpatient clinic with minor trauma and whose general condition is well, is more beneficial.

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