Research Article
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Year 2023, , 25 - 29, 12.01.2023
https://doi.org/10.32322/jhsm.1189019

Abstract

References

  • Kottmeier SA, Row E, Tornetta P, Jones CB, Lorich DG, Watson JT. Surgical exposure trends and controversies in extremity fracture care. Instr Course Lect 2016; 65: 3-23.
  • Menon RP, Chowdhury SK, Semi RS, Gupta V, Rahman S, Balasundaram T. Comparison of ultrasonography with conventional radiography in the diagnosis of zygomatic complex fractures. J Craniomaxillofac Surg 2016; 44: 353-6.
  • Allen GM, Wilson DJ, Bullock SA, Watson M. Extremity CT and ultrasound in the assessment of ankle injuries: occult fractures and ligament injuries. Br J Radiol 2020; 93: 20180989.
  • Singh KS, Jayachandran S. A comparative study on the diagnostic utility of ultrasonography with conventional radiography and computed tomography scan in detection of zygomatic arch and mandibular fractures. Contemp Clin Dent 2014; 5: 166-9.
  • Ackermann O, Simanowski J, Eckert K. Fracture ultrasound of the extremities. Ultraschall Med 2020; 41: 12-28.
  • Fisher JS, Kazam JJ, Fufa D, Bartolotta RJ. Radiologic evaluation of fracture healing. Skeletal Radiol 2019; 48: 349-61.
  • ter Haar G. Therapeutic applications of ultrasound. Prog Biophys Mol Biol 2007; 93: 111-29.
  • Døssing K, Mechlenburg I, Hansen LB, Søballe K, Østergaard H. The use of ultrasound to exclude extremity fractures in adults. JB JS Open Access 2017; 2: e0007.
  • Fukushima Y, Ray J, Kraus E, Syrop IP, Fredericson M. A review and proposed rationale for the use of ultrasonography as a diagnostic modality in the identification of bone stress injuries. J Ultrasound Med 2018; 37: 2297-307.
  • Adeyemo WL, Akadiri OA. A systematic review of the diagnostic role of ultrasonography in maxillofacial fractures. Int J Oral Maxillofac Surg 2011; 40: 655-61.
  • Schmid GL, Kühnast B, Heise M, Deutsch T, Frese T. Ultrasonography in assessing suspected bone fractures: a cross-sectional survey amongst German general practitioners. BMC Fam Pract 2020; 21: 9.
  • Martinoli C. Musculoskeletal ultrasound: technical guidelines. Insights Imaging 2010; 1: 99-141.
  • Pinto A, Berritto D, Russo A, et al. Traumatic fractures in adults: missed diagnosis on plain radiographs in the emergency department. Acta Biomed 2018; 89: 111-23.
  • Chen H, Rogalski MM, Anker JN. Advances in functional X-ray imaging techniques and contrast agents. Phys Chem Chem Phys 2012; 14: 13469-86.
  • Wang H, Feng C, Liu H, et al. Epidemiologic features of traumatic fractures in children and adolescents: a 9-year retrospective study. Biomed Res Int 2019; 2019: 8019063-8019063.
  • Khorgami Z, Fleischer WJ, Chen Y-JA, Mushtaq N, Charles MS, Howard CA. Ten-year trends in traumatic injury mechanisms and outcomes: a trauma registry analysis. Am J Surg 2018; 215: 727-34.
  • Bozorgi F, Shayesteh Azar M, Montazer SH, Chabra A, Heidari SF, Khalilian A. Ability of ultrasonography in detection of different extremity bone fractures; a case series study. Emerg (Tehran) 2017; 5: e15.
  • Salaffi F, Gutierrez M, Carotti M. Ultrasound versus conventional radiography in the assessment of bone erosions in rheumatoid arthritis. Clin Exp Rheumatol 2014; 32: S85-90.
  • Manthey DE, Storrow AB, Milbourn JM, Wagner BJ. Ultrasound versus radiography in the detection of soft-tissue foreign bodies. Ann Emerg Med 1996; 28: 7-9.
  • Patel DD, Blumberg SM, Crain EF. The utility of bedside ultrasonography in identifying fractures and guiding fracture reduction in children. Pediatric Emergency Care 2009; 25: 221-5.
  • Dallaudière B, Larbi A, Lefere M, et al. Musculoskeletal injuries in a resource-constrained environment: comparing diagnostic accuracy of on-the-spot ultrasonography and conventional radiography for bone fracture screening during the Paris-Dakar rally raid. Acta Radiol Open 2015; 4: 2058460115577566-2058460115577566.
  • Epema AC, Spanjer MJB, Ras L, Kelder JC, Sanders M. Point-of-care ultrasound compared with conventional radiographic evaluation in children with suspected distal forearm fractures in the Netherlands: a diagnostic accuracy study. Emerg Med J 2019; 36: 613-6.
  • Tsung JW, Blaivas M. Rapid screening for the posterior fat pad sign in suspected pediatric elbow fractures using point-of-care ultrasound: a “FAST exam” for the traumatized elbow. Critical Ultrasound J 2010; 1: 111-6.
  • Avcı M, Kozacı N, Beydilli İ, Yılmaz F, Eden AO, Turhan S. The comparison of bedside point-of-care ultrasound and computed tomography in elbow injuries. Am J Emerg Med 2016; 34: 2186-90.
  • Beltrame V, Stramare R, Rebellato N, Angelini F, Frigo AC, Rubaltelli L. Sonographic evaluation of bone fractures: a reliable alternative in clinical practice? Clinical Imaging 2012; 36: 203-8.

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

Year 2023, , 25 - 29, 12.01.2023
https://doi.org/10.32322/jhsm.1189019

Abstract

Aim: The purpose of the study is to compare the diagnostic accuracy (sensitivity and specificity) of ultrasonography (USG) with that of conventional radiography (CR), the standard imaging modality used to diagnose acute extremities fractures.
Material and Method: The prospective investigation examined 245 patients with clinical symptoms of an extremity fracture. Radiography (anteroposterior and lateral radiographs for each patient, oblique if necessary) and USG were performed on all participants and compared with all the results.
Results: CR verified 98.5% of 132 patients who were determined to have extremities fractures with USG. CR, on the other hand, confirmed 99.1% of 112 patients who were reported to have no extremities fractures by USG. The sensitivity (detection of fractures based on USG of patients with fractures detected based on the CR imaging) was 99.2% (95%CI=95.8-99.9); selectivity (no fracture was detected based on USG of patients with no fracture detected based on the CR imaging) was 98.2% (95%CI=93.8-99.7); the positive predictability was 98.48% (95%CI=94.2-99.6), whereas the negative predictability value was 99.1%(95%CI=94-99.8).
Conclusion: USG and CR showed similar diagnostic performances in the diagnosis of extremity fractures. USG can be considered an alternative to CR in the examination of extremity fractures with comparable diagnostic performance. 

References

  • Kottmeier SA, Row E, Tornetta P, Jones CB, Lorich DG, Watson JT. Surgical exposure trends and controversies in extremity fracture care. Instr Course Lect 2016; 65: 3-23.
  • Menon RP, Chowdhury SK, Semi RS, Gupta V, Rahman S, Balasundaram T. Comparison of ultrasonography with conventional radiography in the diagnosis of zygomatic complex fractures. J Craniomaxillofac Surg 2016; 44: 353-6.
  • Allen GM, Wilson DJ, Bullock SA, Watson M. Extremity CT and ultrasound in the assessment of ankle injuries: occult fractures and ligament injuries. Br J Radiol 2020; 93: 20180989.
  • Singh KS, Jayachandran S. A comparative study on the diagnostic utility of ultrasonography with conventional radiography and computed tomography scan in detection of zygomatic arch and mandibular fractures. Contemp Clin Dent 2014; 5: 166-9.
  • Ackermann O, Simanowski J, Eckert K. Fracture ultrasound of the extremities. Ultraschall Med 2020; 41: 12-28.
  • Fisher JS, Kazam JJ, Fufa D, Bartolotta RJ. Radiologic evaluation of fracture healing. Skeletal Radiol 2019; 48: 349-61.
  • ter Haar G. Therapeutic applications of ultrasound. Prog Biophys Mol Biol 2007; 93: 111-29.
  • Døssing K, Mechlenburg I, Hansen LB, Søballe K, Østergaard H. The use of ultrasound to exclude extremity fractures in adults. JB JS Open Access 2017; 2: e0007.
  • Fukushima Y, Ray J, Kraus E, Syrop IP, Fredericson M. A review and proposed rationale for the use of ultrasonography as a diagnostic modality in the identification of bone stress injuries. J Ultrasound Med 2018; 37: 2297-307.
  • Adeyemo WL, Akadiri OA. A systematic review of the diagnostic role of ultrasonography in maxillofacial fractures. Int J Oral Maxillofac Surg 2011; 40: 655-61.
  • Schmid GL, Kühnast B, Heise M, Deutsch T, Frese T. Ultrasonography in assessing suspected bone fractures: a cross-sectional survey amongst German general practitioners. BMC Fam Pract 2020; 21: 9.
  • Martinoli C. Musculoskeletal ultrasound: technical guidelines. Insights Imaging 2010; 1: 99-141.
  • Pinto A, Berritto D, Russo A, et al. Traumatic fractures in adults: missed diagnosis on plain radiographs in the emergency department. Acta Biomed 2018; 89: 111-23.
  • Chen H, Rogalski MM, Anker JN. Advances in functional X-ray imaging techniques and contrast agents. Phys Chem Chem Phys 2012; 14: 13469-86.
  • Wang H, Feng C, Liu H, et al. Epidemiologic features of traumatic fractures in children and adolescents: a 9-year retrospective study. Biomed Res Int 2019; 2019: 8019063-8019063.
  • Khorgami Z, Fleischer WJ, Chen Y-JA, Mushtaq N, Charles MS, Howard CA. Ten-year trends in traumatic injury mechanisms and outcomes: a trauma registry analysis. Am J Surg 2018; 215: 727-34.
  • Bozorgi F, Shayesteh Azar M, Montazer SH, Chabra A, Heidari SF, Khalilian A. Ability of ultrasonography in detection of different extremity bone fractures; a case series study. Emerg (Tehran) 2017; 5: e15.
  • Salaffi F, Gutierrez M, Carotti M. Ultrasound versus conventional radiography in the assessment of bone erosions in rheumatoid arthritis. Clin Exp Rheumatol 2014; 32: S85-90.
  • Manthey DE, Storrow AB, Milbourn JM, Wagner BJ. Ultrasound versus radiography in the detection of soft-tissue foreign bodies. Ann Emerg Med 1996; 28: 7-9.
  • Patel DD, Blumberg SM, Crain EF. The utility of bedside ultrasonography in identifying fractures and guiding fracture reduction in children. Pediatric Emergency Care 2009; 25: 221-5.
  • Dallaudière B, Larbi A, Lefere M, et al. Musculoskeletal injuries in a resource-constrained environment: comparing diagnostic accuracy of on-the-spot ultrasonography and conventional radiography for bone fracture screening during the Paris-Dakar rally raid. Acta Radiol Open 2015; 4: 2058460115577566-2058460115577566.
  • Epema AC, Spanjer MJB, Ras L, Kelder JC, Sanders M. Point-of-care ultrasound compared with conventional radiographic evaluation in children with suspected distal forearm fractures in the Netherlands: a diagnostic accuracy study. Emerg Med J 2019; 36: 613-6.
  • Tsung JW, Blaivas M. Rapid screening for the posterior fat pad sign in suspected pediatric elbow fractures using point-of-care ultrasound: a “FAST exam” for the traumatized elbow. Critical Ultrasound J 2010; 1: 111-6.
  • Avcı M, Kozacı N, Beydilli İ, Yılmaz F, Eden AO, Turhan S. The comparison of bedside point-of-care ultrasound and computed tomography in elbow injuries. Am J Emerg Med 2016; 34: 2186-90.
  • Beltrame V, Stramare R, Rebellato N, Angelini F, Frigo AC, Rubaltelli L. Sonographic evaluation of bone fractures: a reliable alternative in clinical practice? Clinical Imaging 2012; 36: 203-8.
There are 25 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Halil Yıldırım 0000-0003-1574-0207

Oya Akpınar Oruç 0000-0003-2515-0956

Publication Date January 12, 2023
Published in Issue Year 2023

Cite

AMA Yıldırım H, Akpınar Oruç O. Comparison of ultrasonography and conventional radiography in the diagnosis of extremity fractures in the emergency department. J Health Sci Med /JHSM /jhsm. January 2023;6(1):25-29. doi:10.32322/jhsm.1189019

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