title: [Sonographic fracture diagnostics].
abstract: BACKGROUND
  In clinically suspected fractures taking radiographs is the standard procedure but the indications should be strictly limited. Ultrasound offers a safe and radiation-free alternative for fracture diagnostics.
  
  
  OBJECTIVE
  Sensitivity and specificity of sonographic fracture diagnostics and safety of sonographic algorithms for fracture evaluation.
  
  
  METHODS
  Presentation of useful applications for sonographic fracture evaluation and establishment of sonographic algorithms for safe fracture diagnosis.
  
  
  RESULTS
  In children distal forearm fractures can be diagnosed solely by ultrasound (sensitivity 96 % and specificity 97 %). The sonographic fat pad sign (SOFA) has been proven to be a useful primary screening tool for occult fractures of the pediatric elbow. A positive fat pad sign (SOFA+) is indicative of a fracture and radiographic diagnostics are necessary (sensitivity 97 % and specificity 91 %). Ultrasonography is also useful to exclude subcapital humeral fractures (sensitivity 94 % and specificity 100 %) and for correct estimation of displacement when present.
  
  
  CONCLUSIONS
  Sonographic algorithms for fracture evaluation (SAFE) offer a safe diagnosis and guidance of the therapeutic course of certain pediatric fractures, thereby reducing unnecessary radiation exposure.
authors: Klinik für Kinderchirurgie, Elisabeth-Krankenhaus Essen, Klara-Kopp-Weg 1, 45138, Essen, Deutschland. k.eckert@contilia.de.
authors: K
authors: K
authors: Eckert
authors: Ruhr-Universität Bochum, Universitätsstrasse 150, 44801, Bochum, Deutschland. dr.med.ackermann@gmx.de.
authors: O
authors: O
authors: Ackermann
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
keywords: Children; Elbow; Fat pad sign; Forearm; Proximal humerus