Usability of Ultrasonography in the Diagnosis of Pediatric Fractures

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064190%3A_____%2F26%3A10001443" target="_blank" >RIV/00064190:_____/26:10001443 - isvavai.cz</a>

Výsledek na webu

<a href="https://doi.org/10.55095/achot2026/002" target="_blank" >https://doi.org/10.55095/achot2026/002</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.55095/achot2026/002" target="_blank" >10.55095/achot2026/002</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Usability of Ultrasonography in the Diagnosis of Pediatric Fractures

Popis výsledku v původním jazyce

Purpose of the study The study aims to evaluate the usability of ultrasonography in the diagnosis of pediatric fractures. Material and methods Ultrasound examination of patients with fractures diagnosed using radiography at the Clinic of Pediatric and Trauma Surgery, Third Faculty of Medicine, Charles University and UTH between 27 May 2024 and 31 December 2024. We identified a total of 11 areas to be examined-clavicle, proximal humerus, elbow, forearm, metacarpal bones, fingers of the upper limb, sternum, femur, tibia, ankle, and metatarsal bones. The examination was performed independently by a surgeon and a radiologist, who selected the patients randomly during their treatment at the clinic. The entire bone was examined by ultrasound in all available projections, and signs of skeletal trauma(cortical bumping, cortical disruption, offset of bone fragments, chimney effect, or indirect signs such as joint effusion)were sought. Results A total of 61 patients were examined, of whom 24 girls (39%) and 37 boys (61%). The mean age of patients was 10 years (1-17 years). The overall agreement between ultrasound and radiologic examinations is 94%. Ultrasonography failed to visualize two fractures, namely anon-displaced SH type II fracture of the distal fibula epiphysis and a nondisplaced SH type III fracture of the distal phalanx epiphysis. Two suspected fractures of the distal forearm detected by radiography were not observed by ultrasonography. The fracture was ruled out by a followup radiography, and the sonographic finding was found to be correct. Discussion Ultrasonography is a usable diagnostic method for skeletal trauma. The estimated sensitivity of this examination is around 97%. Our results indicate greater specificity of ultrasound in the forearm region. In agreement with literature, ultrasound can be considered usable for the diagnosis of fractures in all examined areas. In certain locations, it can also be used to measure displacement. The weak point of the study is the limited number of patients, therefore further investigation into these matters is necessary. Conclusions Ultrasonography appears to be a useful screening method for skeletal trauma in children, serving as a basis for indication for radiography. This could help reduce the number of radiologic examinations performed by up to two-thirds, thereby reducing the radiation exposure in pediatric patients. Further research on these matters is needed, and diagnostic reliability indicators shall be defined. In the phase two of the study, we plan to determine the sensitivity, specificity, positive and negative predictive values for all anatomical regions. The secondary objective is to evaluate the results achieved by the surgeon and the radiologist, the painfulness of the examination, and the usability of portable ultrasound devices.

Název v anglickém jazyce

Usability of Ultrasonography in the Diagnosis of Pediatric Fractures

Popis výsledku anglicky

Purpose of the study The study aims to evaluate the usability of ultrasonography in the diagnosis of pediatric fractures. Material and methods Ultrasound examination of patients with fractures diagnosed using radiography at the Clinic of Pediatric and Trauma Surgery, Third Faculty of Medicine, Charles University and UTH between 27 May 2024 and 31 December 2024. We identified a total of 11 areas to be examined-clavicle, proximal humerus, elbow, forearm, metacarpal bones, fingers of the upper limb, sternum, femur, tibia, ankle, and metatarsal bones. The examination was performed independently by a surgeon and a radiologist, who selected the patients randomly during their treatment at the clinic. The entire bone was examined by ultrasound in all available projections, and signs of skeletal trauma(cortical bumping, cortical disruption, offset of bone fragments, chimney effect, or indirect signs such as joint effusion)were sought. Results A total of 61 patients were examined, of whom 24 girls (39%) and 37 boys (61%). The mean age of patients was 10 years (1-17 years). The overall agreement between ultrasound and radiologic examinations is 94%. Ultrasonography failed to visualize two fractures, namely anon-displaced SH type II fracture of the distal fibula epiphysis and a nondisplaced SH type III fracture of the distal phalanx epiphysis. Two suspected fractures of the distal forearm detected by radiography were not observed by ultrasonography. The fracture was ruled out by a followup radiography, and the sonographic finding was found to be correct. Discussion Ultrasonography is a usable diagnostic method for skeletal trauma. The estimated sensitivity of this examination is around 97%. Our results indicate greater specificity of ultrasound in the forearm region. In agreement with literature, ultrasound can be considered usable for the diagnosis of fractures in all examined areas. In certain locations, it can also be used to measure displacement. The weak point of the study is the limited number of patients, therefore further investigation into these matters is necessary. Conclusions Ultrasonography appears to be a useful screening method for skeletal trauma in children, serving as a basis for indication for radiography. This could help reduce the number of radiologic examinations performed by up to two-thirds, thereby reducing the radiation exposure in pediatric patients. Further research on these matters is needed, and diagnostic reliability indicators shall be defined. In the phase two of the study, we plan to determine the sensitivity, specificity, positive and negative predictive values for all anatomical regions. The secondary objective is to evaluate the results achieved by the surgeon and the radiologist, the painfulness of the examination, and the usability of portable ultrasound devices.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30211 - Orthopaedics

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2026

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE CECHOSLOVACA

ISSN

0001-5415

e-ISSN

—

Svazek periodika

93

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

7

Strana od-do

40-46

Kód UT WoS článku

001720534400005

EID výsledku v databázi Scopus

2-s2.0-105034283288