Diagnostic accuracy of bedside emergency ultrasound screening for fractures in pediatric trauma patients

J Emerg Trauma Shock. 2011 Oct;4(4):443-5. doi: 10.4103/0974-2700.86625.

Abstract

Background: Bedside ultrasound (BUS) can effectively identify fractures in the emergency department (ED).

Aim: To assess the diagnostic accuracy of BUS for fractures in pediatric trauma patients.

Setting and design: Prospective observational study conducted in the ED.

Material and methods: Pediatric patients with upper and lower limb injuries requiring radiological examination were included. BUS examinations were done by emergency physicians who had undergone a brief training. X-rays were reviewed for the presence of fracture and the results of BUS and radiography were compared.

Statistical analysis: STATA version 11 was used for statistical analysis of the data.

Results: Forty-one patients were enrolled in the study. The sensitivity of the BUS in detecting fracture was 89% [95% confidence interval (CI): 51% to 99%] and the specificity was 100% (95% CI: 87% to 100%). The positive predictive value of BUS was 100% and negative predictive value was 97%.

Conclusion: BUS can be utilized by emergency physicians after brief training to accurately identify long bone fractures in the pediatric age-group.

Keywords: Emergency department; fracture; pediatric; ultrasound.