title: The comparison of radiography and point-of-care ultrasonography in the diagnosis and management of metatarsal fractures.
abstract: OBJECTIVE
  It was aimed to compare the efficacy of point-of-care ultrasonography (POCUS) with radiography in the diagnosis and management of metatarsal fracture (MTF).
  
  
  METHODS
  Patients aged 5-55 years admitted to emergency room due to low-energy, simple extremity trauma and had a suspected MTF, were included in this prospective study. Patients were evaluated by two different emergency physicians in the emergency room. The first physician performed POCUS examination. Second physician evaluated the radiography images. The obtained results were compared.
  
  
  RESULTS
  Seventy-two patients were enrolled in the study. Fracture was detected in 39% by radiography and in 43% of patients by POCUS. Multiple MTFs were identified in 5% of patients. Compared with radiography, POCUS had a sensitivity of 93%, specificity of 89%, positive predictive value of 84% and a negative predictive value of 95% (95% CI, 83-98%) in the detection of fractures. While soft tissue edema was seen in 61% of patients by POCUS, soft tissue edema with hematoma was detected in 14%. Compared with radiography, the sensitivity and specificity of POCUS in the decision for surgery were 100% and 98% (95% CI, 97-100%), respectively, whereas its sensitivity and specificity were both 100% in the decision for reduction.
  
  
  CONCLUSIONS
  In our study, we demonstrated that POCUS could be applied with success in the diagnosis and treatment of MTF in low-energy injuries. POCUS can be used as an alternative to radiography in the emergency rooms due to being easy to learn and practice and availability of soft tissue examination along with bone tissue examination.
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey. Electronic address: nalankozaci@gmail.com.
authors.forename: Nalan
authors.initials: N
authors.lastname: Kozaci
authors.affiliation: Hitit University, Corum Training and Research Hospital, Department of Emergency Medicine, Corum, Turkey.
authors.forename: Mehmet Oguzhan
authors.initials: MO
authors.lastname: Ay
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Avci
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey.
authors.forename: Inan
authors.initials: I
authors.lastname: Beydilli
authors.affiliation: Antalya Training and Research Hospital, Department of Ortopedia and Traumatology, Antalya, Turkey.
authors.forename: Sadullah
authors.initials: S
authors.lastname: Turhan
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey.
authors.forename: Eda
authors.initials: E
authors.lastname: Donertas
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey.
authors.forename: Ertan
authors.initials: E
authors.lastname: Ararat
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging* / Q000293:injuries / Q000473:pathology; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000706:statistics & numerical data; D011446:Prospective Studies; D011859:Radiography; D012680:Sensitivity and Specificity; D014421:Turkey; D014463:Ultrasonography; D055815:Young Adult
keywords: Diagnosis; Fracture; Metatarsal; Orthopedics; Radiography; Ultrasonography