title: Diagnostic accuracy of bedside emergency ultrasound screening for fractures in pediatric trauma patients.
abstract: BACKGROUND
  Bedside ultrasound (BUS) can effectively identify fractures in the emergency department (ED).
  
  
  OBJECTIVE
  To assess the diagnostic accuracy of BUS for fractures in pediatric trauma patients.
  
  
  METHODS
  Prospective observational study conducted in the ED.
  
  
  METHODS
  Pediatric patients with upper and lower limb injuries requiring radiological examination were included. BUS examinations were done by emergency physicians who had undergone a brief training. X-rays were reviewed for the presence of fracture and the results of BUS and radiography were compared.
  
  
  METHODS
  STATA version 11 was used for statistical analysis of the data.
  
  
  RESULTS
  Forty-one patients were enrolled in the study. The sensitivity of the BUS in detecting fracture was 89% [95% confidence interval (CI): 51% to 99%] and the specificity was 100% (95% CI: 87% to 100%). The positive predictive value of BUS was 100% and negative predictive value was 97%.
  
  
  CONCLUSIONS
  BUS can be utilized by emergency physicians after brief training to accurately identify long bone fractures in the pediatric age-group.
authors.affiliation: Departments of Surgery, JPN Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Tej P
authors.initials: TP
authors.lastname: Sinha
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Bhoi
authors.forename: Sudeep
authors.initials: S
authors.lastname: Kumar
authors.forename: Radhakrishna
authors.initials: R
authors.lastname: Ramchandani
authors.forename: Ankur
authors.initials: A
authors.lastname: Goswami
authors.forename: Lalit
authors.initials: L
authors.lastname: Kurrey
authors.forename: Sagar
authors.initials: S
authors.lastname: Galwankar
references.citation: Eur Radiol. 2007 Mar;17(3):762-7
references.pmid: 16758160
references.citation: Radiology. 1992 Jan;182(1):201-4
references.pmid: 1727282
references.citation: Eur Radiol. 2006 Nov;16(11):2542-8
references.pmid: 16786321
references.citation: J Pediatr Orthop. 2009 Mar;29(2):142-5
references.pmid: 19352239
references.citation: J Bone Joint Surg Br. 2000 Nov;82(8):1170-3
references.pmid: 11132281
references.citation: Pediatr Emerg Care. 2009 Apr;25(4):221-25
references.pmid: 19382318
references.citation: J Trauma. 2005 Sep;59(3):677-81
references.pmid: 16361912
references.citation: J Emerg Med. 2011 Mar;40(3):308-12
references.pmid: 19959315
references.citation: Pediatr Emerg Care. 2007 Aug;23(8):528-31
references.pmid: 17726410
references.citation: AJR Am J Roentgenol. 1990 Jan;154(1):125-8
references.pmid: 2104695
references.citation: J Bone Joint Surg Br. 1995 Sep;77(5):788-90
references.pmid: 7559712