Ultrasound in the Diagnostics of Metaphyseal Forearm Fractures in Children

Abstract

Sensitivity and specificity of ultrasound examinations are high. Single study results show that sonographic examinations can be faster and less painful. In addition, the calculation model shows a tendency towards less-expensive ultrasound examinations.Further studies are needed with an adequate sample size calculation for assessing equivalence or non-inferiority of ultrasound and x-ray and to collect data on pain, examination time, and costs. The age of the older participants may be problematic because of the fact that epiphyseal plates close within the age from 15 to 22 years, which may influence the diagnostic accuracy of sonographic examinations. Therefore, future studies should contain age-stratified analyses. In addition, the calculation model for costs should be tested on a wider data base.

Ultrasonography to Assess Suspected Bone Fractures: Beliefs and Usage in General Practice in Germany – A Cross-Sectional Survey

“…In a systematic review Chartier et al [3] reported on 30 publications showing a high sensitivity (64.7-100%) and specificity (79.2-100%) compared to plain radiographs in patients with suspected fracture of the long bones. Two more systematic reviews [4,5] focused on distal forearm fractures only and found an even higher accuracy. An overview for the diagnostic accuracy of ultrasonography used for different fracture locations and patient groups was published by Schmid et al [6].…”

“…The main advantages of US compared to conventional radiography are no radiation exposure, lower costs [5], and wider availability in non-hospital settings. Moreover, evidence suggests US may have higher accuracy than conventional radiographs for certain injuries, such as rib fractures [9] and early scaphoid fractures [10].…”

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

“…In addition to the diagnostic evaluation of inner organs, blood vessels, muscles, and soft tissues, it has been demonstrated that US has a high sensitivity and specificity for the diagnosis of suspected bone fractures [3][4][5][6][7]. The detection of cortical discontinuities, step formation, and subperiosteal hematoma can be used as a diagnostic tool after acute trauma.…”

Indikationen zur sonographischen Frakturdiagnostik von Frakturen im Wachstumsalter

“…Erst in den letzten Jahren jedoch erlaubte der strukturierte Vergleich mit der Röntgendiagnostik [3,4,7,8,10,11,[19][20][21] die Entwicklung suffizienter Algorithmen und damit die Möglichkeit der flächendeckenden Anwendung. Mit der Sonographie lassen sich bei gleicher diagnostischer Qualität im Vergleich zum Röntgenbild die Abläufe erheblich beschleunigen und die Kosten senken [18].…”

“…Bei radiologischen Untersuchungen fallen deutlich längere Wartezeiten, ein erhöhter Personalaufwand und mindestens 2 Arzt-Patienten-Kontakte an. Nach einer systematischen Analyse ergibt sich für die Fraktursonographie auch bei den Gesamtkosten eine Ersparnis von 23 %[18] gegenüber der Röntgenbildgebung.…”