title: Ultrasound as an adjunct to radiography in minor musculoskeletal pediatric trauma.
abstract: OBJECTIVE
  To assess the value of ultrasound as an adjunct to radiography in minor musculoskeletal pediatric trauma.
  
  
  METHODS
  Fifty children with 53 suspected fractures were referred for upper and/or lower limbs X-rays, followed by ultrasound. On radiography, we noted presence of fracture, of soft tissue thickening, or absence of any lesion. On ultrasound, we noted presence of fracture, of soft tissue lesion, or absence of lesions.
  
  
  RESULTS
  A fracture was seen on both examinations in 25 patients with 28 fractures.In 4 patients where only soft tissue thickening was seen on radiography, ultrasound showed fracture in 1 patient, hematoma in 1 patient and was normal in 2 patients. In another patient with a doubtful diagnosis of fracture on radiography, ultrasound was normal. In 20 patients with normal X-rays, ultrasound showed fracture in 6 patients, hematoma in 7 patients and was normal in 7 patients.
  
  
  CONCLUSIONS
  Ultrasound was helpful as an adjunct to radiography, it yielded additional bone (7/50 patients) and soft tissue (8/50 patients) diagnostic information in 30% of patients. However, ultrasound remains operator-dependent and can be used only in particular circumstances, especially in children with normal X-rays and a high index of clinical suspicion for an occult or subradiological fracture.
authors.affiliation: Departments of Radiology, CHU Hôtel-Dieu de France, Beirut, Lebanon. aksamer@hotmail.com
authors.forename: Khalil Samer
authors.initials: KS
authors.lastname: Abi
authors.forename: Soha
authors.initials: S
authors.lastname: Haddad-Zebouni
authors.forename: Sami
authors.initials: S
authors.lastname: Roukoz
authors.forename: Tarek
authors.initials: T
authors.lastname: Smayra
authors.forename: Hachem
authors.initials: H
authors.lastname: Kamal
authors.forename: Lina
authors.initials: L
authors.lastname: Menassa-Moussa
authors.forename: Noël J
authors.initials: NJ
authors.lastname: Aoun
authors.forename: Michel A
authors.initials: MA
authors.lastname: Ghossain
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D009141:Musculoskeletal System / Q000000981:diagnostic imaging* / Q000293:injuries*; D011446:Prospective Studies; D011859:Radiography; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging*; D014463:Ultrasonography