Ultrasonography in assessing suspected bone fractures: a cross-sectional survey amongst German general practitioners

Abstract

Background: Over the last two decades, ultrasonography (US) has been shown to be an accurate tool for the diagnosis of suspected bone fractures; however, the integration of this application of US into routine care and outpatient settings needs to be explored. In this study, we surveyed German general practitioners (GPs) to assess their knowledge, attitudes, and utilization of US for the diagnosis of suspected fractures. Methods: Notification of the study, a self-designed questionnaire, and a reminder were mailed to 600 randomly selected GPs in Saxony and Saxony-Anhalt. Results: The response rate was 47.7% (n = 286), and respondents did not differ from the population of all GPs in respect to sex and practice type. Among GPs surveyed, 48.6% used an US device in their practice. On average, GPs diagnosed six patients with suspected fractures per month, yet only 39.3% knew about the possibility of ultrasonographic fracture diagnosis, and only 4.3% of GPs using US applied it for this purpose. Among participants, 71.9% believed that US is inferior to conventional X-rays for the diagnosis of bony injuries. Users of US were better informed of and more commonly used US for fracture diagnosis compared to non-users. Conclusion: The need to rule out possible fractures frequently arises in general practice, and US devices are broadly available. Further efforts are needed to improve the knowledge and attitudes of GPs regarding the accuracy of US for fracture diagnosis. Multicenter controlled trials could explore the safety, usefulness, and effectiveness of this still seldom used diagnostic approach for suspected fractures.

Comparative use of ultrasound and radiography for the detection of fractures: a systematic review and narrative synthesis

“…The majority of responders (71.9%, n =192/267) stated that the US was less successful than traditional XRs in diagnosing bone injuries. Despite the fact that 39.3% ( n =110/280) of clinicians were aware of this imaging technology, only 19.1% ( n =54/283) considered it important to their own practice, and only 7.8% ( n =22/282) had any practical e41%) experience using US to detect fractures 11 .…”

“…A study revealed only 39.3% of clinical practitioners in Germany were aware of the applications of US in fracture diagnosis and 71.9% believed US to be less efficient than XR. However, users of US were found to be well informed 11 .…”

Comparison of ultrasonography and conventional radiography in the diagnosis of extremity fractures in the emergency department

“…The avoidance of radiation exposure is one of the primary benefits of ultrasonic testing; this is especially true in pregnant and children, who are more vulnerable to radiation than adults (10). Ultrasonography as a diagnostic tool in situations of suspected fractures may offer economic, prognostic, and therapeutic benefits, particularly in terms of reducing unnecessary radiation exposure to human body (11).…”