[Is ultrasound equal to X-ray in pediatric fracture diagnosis?].
OBJECTIVE
Ultrasound is currently not established for the diagnosis of fractures. The aim of this study was to compare ultrasound and X-ray beyond their use solely for the identification of fractures, i. e., for the detection of fracture type and dislocation for pediatric fracture diagnosis.


METHODS
Limb bones of dead young pigs served as a model for pediatric bones. The fractured bones were examined with ultrasound, X-ray, and CT, which served as the gold standard.


RESULTS
162 of 248 bones were fractured. 130 fractures were identified using ultrasound, and 148 using X-ray. There were some advantages of X-ray over ultrasound in the detection of fracture type (80 correct results using X-ray, 66 correct results using ultrasound). Ultrasound, however, was superior to X-ray for dislocation identification (41 correct results using X-ray, 51 correct results using ultrasound). Both findings were not statistically significant after adjustment for multiple testing.


CONCLUSIONS
Ultrasound not only has comparable sensitivity to that of X-ray for the identification of limb fractures but is also equally effective for the diagnosis of fracture type and dislocation. Thus, ultrasound can be used as an adequate alternative method to X-ray for pediatric fracture diagnosis.
Moritz
J D
JD
Klinik für Diagnostische Radiologie, Pädiatrische Radiologie und Sonografie, UK-SH, Campus Kiel. joerg.d.moritz@rad.uni-kiel.de
Hoffmann
B
B
Meuser
S H
SH
Sehr
D H
DH
Caliebe
A
A
Heller
M
M
D000367:Age Factors; D000818:Animals; D001842:Bone and Bones / Q000473:pathology; D002648:Child; D004195:Disease Models, Animal; D050723:Fractures, Bone / Q000145:classification / Q000175:diagnosis*; D005596:Fractures, Closed / Q000145:classification / Q000175:diagnosis; D018460:Fractures, Comminuted / Q000145:classification / Q000175:diagnosis; D006132:Growth Plate / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D057072:Intra-Articular Fractures / Q000145:classification / Q000175:diagnosis; D000072042:Salter-Harris Fractures; D012680:Sensitivity and Specificity; D013552:Swine; D036542:Tomography, Spiral Computed; D014463:Ultrasonography