Role of sonography in the emergency room to diagnose sternal fractures.
BACKGROUND
The diagnosis of a sternal fracture is often difficult when the fracture site shows only minimal displacement on conventional radiography. Recently, sonography (US) has been used widely in the emergency room (ER). We investigated the diagnostic performance of US in the ER for the diagnosis of sternal fractures.


METHODS
Thirty-six consecutive patients examined for pain and tenderness in the sternum after blunt chest trauma were enrolled in the study. Antero-posterior and lateral radiographs and sonograms of the sternum were obtained within 24 hours after admission. The 2 imaging modalities were interpreted in a blinded manner and their diagnostic sensitivity and specificity were calculated. The final diagnosis was based on results from the clinical examination, radiographs, and sonograms.


RESULTS
Twenty-four of the 36 patients were diagnosed with sternal fractures. The sensitivity and specificity of the plain radiographs were 70.8% (95% CI = 56.0-85.6%) and 75.0% (95% CI = 60.9-89.1%), respectively. In contrast, sonography had a 100% sensitivity and specificity (95% CI = 90.3-100%).


CONCLUSIONS
US has a higher sensitivity and specificity in diagnosing sternal fractures than conventional radiographs. US should be considered in patients with symptoms suggesting sternal fractures whose radiographs remain indeterminate.
You
Je Sung
JS
Department of Emergency Medicine and Critical Care Medicine, Seo-Ulsan Boram Hospital, Ulsan, Republic of Korea.
Chung
Yong Eun
YE
Kim
Donghyun
D
Park
Saehwan
S
Chung
Sung Pil
SP
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011859:Radiography; D012680:Sensitivity and Specificity; D013249:Sternum / Q000000981:diagnostic imaging* / Q000293:injuries*; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*; D055815:Young Adult