Sonography versus plain x rays in diagnosis of nasal fractures.
BACKGROUND
The standard imaging procedure for suspected nasal fractures has been radiography (XR). However, its usefulness for clinical decision making is highly controversial. High-resolution ultrasonography now offers a promising new diagnostic imaging option. In this study we compared the diagnostic value of high-resolution ultrasonography and conventional XR in the evaluation of suspected nasal fractures.


METHODS
A prospective single-blinded study was performed. Ultrasound (US) and XR findings in 80 patients with suspected nasal fractures were compared with the definite clinical diagnosis with respect to sensitivity, specificity, and accuracy.


RESULTS
For detection of fractures of the nasal dorsum, both modalities had high sensitivity (98 and 88% for US and XR, respectively) and specificity (95% for both US and XR). In lateral nasal wall fractures, specificity was higher for XR (75% versus 94%). Sensitivity was significantly higher for the US examination (98% versus 28%). In summary, the accuracy was higher for US.


CONCLUSIONS
When available, US should be the first-line imaging procedure in the evaluation of nasal fractures.
Gürkov
Robert
R
Klinik für Hals, Nasen-und Ohrenheilkunde, Ludwig-Maximilians-Universität München, Germany. robert.guerkov@med.uni-muenchen.de
Clevert
Dirk
D
Krause
Eike
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009295:Nasal Bone / Q000293:injuries*; D011446:Prospective Studies; D011859:Radiography; D012680:Sensitivity and Specificity; D012887:Skull Fractures / Q000000981:diagnostic imaging*; D014463:Ultrasonography