Use of radiography and ultrasonography for nasal fracture identification in children under 18 years of age presenting to the ED

Doğan, Serkan; Kalafat, Utku Murat; Yüksel, Bülent Cavit; Karaboga, Turker; Baştürk, Mustafa; Ocak, Tarık

doi:10.1016/j.ajem.2016.11.056

Cited by 9 publications

(11 citation statements)

References 12 publications

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“…[16] US for nasal fracture identification was evaluated for adults [17,18] and children. [19] All studies concluded that US was better than direct radiography and computed tomography for proper diagnosis [3,[20][21][22] of isolated nasal fracture. Implementing the US for the nose fracture diagnosis could be a solution to reduce the number of diagnostic errors and overuse of radiography in the ED.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic errors of nasal fractures in the emergency department: A monocentric retrospective study

Rebours¹,

Glatre²,

Plaisance³

et al. 2022

World Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Diagnostic errors of nasal fractures in the emergency department: A monocentric retrospective study

Rebours¹,

Glatre²,

Plaisance³

et al. 2022

World Journal of Emergency Medicine

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“…When the studies conducted in the pediatric age group were examined, Hong et al 5 were able to detect all fracture lines by ultrasonography in their study involving 26 pediatric patients. Doğan et al 18 detected the sensitivity and specificity of ultrasonography as 22.5% and 83.1%, respectively, in their study of 133 patients. In our study, we found the sensitivity and specificity of ultrasonography in detecting nasal fractures as 72.2% (95% CI: 46.5–90.3) and 76.9% (95% CI: 46.2–95.0), respectively.…”

Section: Discussionmentioning

confidence: 94%

“…However, there is no information about patients without nasal fracture in this comparison. Doğan et al 18 compared the results of radiography and USG to determine nasal fractures. They reported that 11 of 34 cases diagnosed with fractures by ultrasonography were detected radiographically, but in the other 23 cases, fractures were not detected radiographically.…”

Section: Discussionmentioning

confidence: 99%

“…The use of bedside ultrasonography in the diagnosis of nasal bone fractures has been the subject of several studies. [18][19][20][21] To our knowledge, however, limited data are available with regard to the diagnostic value of ultrasonography in nasal fractures of children. In this study, we aimed to investigate the diagnostic accuracy of bedside ultrasonography in children and to detect whether it is a preferable alternative method to CR.…”

Section: Introductionmentioning

confidence: 99%

“…The use of bedside ultrasonography in the diagnosis of nasal bone fractures has been the subject of several studies 18–21 . To our knowledge, however, limited data are available with regard to the diagnostic value of ultrasonography in nasal fractures of children.…”

Section: Introductionmentioning

confidence: 99%

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Ability of Bedside Ultrasonography to Detect Pediatric Nasal Bone Fractures

et al. 2020

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Objectives/Hypothesis: The aims of this study were to evaluate the diagnostic test features of bedside ultrasonography in pediatric patients with nasal trauma and to investigate whether it is a preferable alternative method to conventional radiography (CR).Study Design: Cross-sectional prospective study.Methods: This prospective study was conducted from March 1, 2019, through November 1, 2019. Thirty-one patients under the age of 18 years who had nasal trauma were consecutively included. CR and ultrasonographic imaging tests were investigated in patients with clinical indications for nasal bone fracture. The sensitivity, specificity, and accuracy of ultrasonography and CR were calculated with respect to detecting nasal fractures according to the gold standard method.Results: Participants were between 3 and 16 years old and the median age was 8 (5-13) years. Nasal bone fracture was clinically detected in 18 patients. While 13 of these fractures were detected with ultrasonography, only 11 were also detected with CR. The sensitivity and specificity of ultrasonography and CR in detecting nasal fractures were 72.2% (95% confidence interval [CI]: 46.5-90.3) and 76.9% (95% CI: 46.2-95.0) for ultrasonography and 61.1% (95% CI: 35.8-82.7) and 69.2% (95% CI: 38.6-90.9) for CR.Conclusions: According to the results of this study, ultrasonography may be used with confidence as a first imaging method in the investigation of nasal fractures, particularly with consideration for avoiding the effects of radiation as much as possible. Our findings point to the next step of conducting trials with a greater number of patients in order to define the diagnostic test features of ultrasonography in pediatric patients.

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Diagnostic utility of ultrasound in pediatric nasal bone fractures: a systematic review and meta-analysis

Hassankhani,

Amoukhteh,

Jannatdoust

et al. 2024

Emerg Radiol

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Ultrasonography, a radiation-free and cost-effective modality, stands out as a promising tool for evaluating nasal bone fractures. Despite limited literature on its pediatric application, there is an increasing recognition of its potential to enhance diagnostic precision. To evaluate the diagnostic efficacy of ultrasound in detecting pediatric nasal bone fractures. Employing established guidelines, a systematic review and meta-analysis were conducted through a comprehensive literature search in PubMed, Scopus, Web of Science, and Embase databases until December 5, 2023. Inclusion criteria encompassed studies reporting diagnostic accuracy measures of ultrasound in pediatric patients with nasal bone fractures. Data extraction and analysis were undertaken for the selected studies. Involving four studies with 277 patients, ultrasound demonstrated a pooled sensitivity of 66.1% (95% CI: 35.1-87.5%) and specificity of 86.8% (95% CI: 80.1-91.4%) in diagnosing pediatric nasal fractures. The area under the receiver operating characteristic curve (AUC) was 0.88 (95% CI: 0.72–0.93). After excluding an outlier study, sensitivity and specificity increased to 78.0% (95% CI: 65.6-86.9%) and 87.8 (95% CI: 78.1-93.6%), respectively, with an AUC of 0.79 (95% CI: 0.75–0.94). Pooled positive and negative likelihood ratios were 5.11 (95% CI: 2.12–9.15) and 0.40 (95% CI: 0.14–0.77) before exclusion and 6.75 (95% CI: 3.47–12.30) and 0.26 (95% CI: 0.15–0.40) after exclusion of an outlier study, respectively. This study highlighted ultrasonography’s utility in diagnosing pediatric nasal bone fractures with high accuracy and specificity. However, caution is advised in relying solely on ultrasound due to suboptimal overall diagnostic performance, evident in likelihood ratios.

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Use of radiography and ultrasonography for nasal fracture identification in children under 18 years of age presenting to the ED

Cited by 9 publications

References 12 publications

Diagnostic errors of nasal fractures in the emergency department: A monocentric retrospective study

Diagnostic errors of nasal fractures in the emergency department: A monocentric retrospective study

Ability of Bedside Ultrasonography to Detect Pediatric Nasal Bone Fractures

Diagnostic utility of ultrasound in pediatric nasal bone fractures: a systematic review and meta-analysis

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