title: Is ultrasound really helpful in the detection of rib fractures?
abstract: OBJECTIVE
  To determine the usefulness of ultrasound in the detection of rib fractures.
  
  
  METHODS
  A prospective study was performed over a 3-month period. Patients presenting with a high clinical suspicion of rib fracture(s) to the Accident and Emergency Department were referred for radiological work-up with a PA chest radiograph, an oblique rib view and a chest ultrasound. Associated lesions, e.g. pleural effusion, splenic laceration and pneumothorax were recorded.
  
  
  RESULTS
  Fourteen patients were radiologically assessed. The mean patient age was 31 years (range 16-55 years) and the M:F ratio 3.7:1 (11 men and 3 women). Ten patients displayed a total of 15 broken ribs. Chest radiography detected 11, oblique rib views 13 and ultrasound 14 broken ribs. Ultrasound findings included discontinuity of cortical alignment in 12 fractures, an acoustic linear edge shadow in nine and a reverberation artifact in six. Concordance with plain film findings, and especially oblique rib views, was good, though better when the rib fractures fragments were markedly displaced. One splenic laceration was detected with an associated small pleural effusion. There were no pneumothoraces. The average time of ultrasound examination was 13 min.
  
  
  CONCLUSIONS
  Ultrasound does not significantly increase the detection rate of rib fractures, may be uncomfortable for the patient and is too time-consuming to justify its routine use to detect rib fractures.
authors.affiliation: Department of Radiology, Adelaide & Meath Hospital and National Children's Hospital, Dublin 24, Ireland. majadonhurley@eircom.net
authors.forename: Maja E
authors.initials: ME
authors.lastname: Hurley
authors.forename: Geoff D
authors.initials: GD
authors.lastname: Keye
authors.forename: Samuel
authors.initials: S
authors.lastname: Hamilton
mesh_terms: D000293:Adolescent; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012253:Rib Fractures / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging