title: Sonographic diagnosis of toddler's fracture in the emergency department.
abstract: We describe 3 cases of toddler's fracture of the tibia that were diagnosed via sonographic examination. In cases, initial radiographs did not show the fracture, whereas sonographic examination revealed a layer of low reflectivity superficial to the tibial cortex and an elevated periosteum, suggesting a fracture hematoma. The diagnosis was confirmed at 2-3 weeks with radiographs demonstrating periosteal reaction. Both fractures were treated with cast immobilization for 4 weeks and made a full recovery. The third case was diagnosed via sonography and was confirmed by the initial radiographs. These results strongly suggest that sonography can detect the presence of a fracture hematoma and thus may help diagnose this injury earlier.
authors.affiliation: The Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk IP4 5PD, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Lewis
authors.forename: Peter
authors.initials: P
authors.lastname: Logan
mesh_terms: D002675:Child, Preschool; D004632:Emergency Medical Services; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011859:Radiography; D012680:Sensitivity and Specificity; D013977:Tibia / Q000000981:diagnostic imaging*; D014463:Ultrasonography