Ultrasound: Bone: Difference between revisions
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===Abnormal=== | ===Abnormal=== | ||
<gallery> | |||
File:Generic fx.png|Fracture | |||
File:Intertroch fx.png|Intertrochanteric Fracture | |||
File:Metacarpal fx.png|Metacarpal Fracture | |||
</gallery> | |||
==Instructions== | ==Instructions== | ||
Revision as of 12:39, 9 January 2015
Background
- U/S can be used to find fractures with high specificity and sensitivity
- U/S is an added option for post-reduction if fluoro is not available
Sensitivity and Specificity
- Fifth metatarsal fracture - SN 0.971 and SP 1.00[1]
- Long bone fracture - SN 0.929 and SP 0.833 (vs PE which is 0.786 and 0.90)[2]
- Rib fracture - SN 0.90 and SP 1.00 (vs CXR with is 0.15 and 1.00)[3]
Images
Normal
Longitudinal view of long bone
Longitudinal view
Transverse view of long bone
Transverse view
Abnormal
Fracture
Intertrochanteric Fracture
Metacarpal Fracture
Instructions
- Use linear probe (high freq probe)
- Place probe in longitudinal plane with bone over site of deformity or maximal pain
- Fan and slide side to side to optimize
- Slide distal to proximal to find tranverse and oblique fractures
- Turn probe 90° to assess for longitudinal and oblique fractures
Findings
- Positive Findings
- Discontinuity in the cortex of the bone
- Hypoechoic fluid collection over the cortex can suggest a hematoma and suggests a fracture could be present
- Negative Findings
- Continuous cortex
Pearls and Pitfalls
- As you enter the joint, there can be discontinuity in the bones but not sharp or abruptly
- A similar discontinuity can be seen over growth plates, but again are not abrupt
- A water bath may aid in searching for fractures in the hands and feet
See Also
External Links
Sources
- ↑ Ha AS, et al. The accuracy of bedside ultrasonography as a diagnostic tool for the fifth metatarsal fractures. The American journal of emergency medicine (Impact Factor: 1.54). 11/2013; DOI: 10.1016/j.ajem.2013.11.00
- ↑ Marshburn, TH, et al. Goal-Directed Ultrasound in the Detection of Long-Bone Fractures. Journal of Trauma-Injury Infection & Critical Care. 2004; 57(2):329-332. doi:10.1097/01.TA.0000088005.35520.CB
- ↑ Griffith, JF, et al. Sonography compared with radiography in revealing acute rib fracture. American Journal of Roentgenology. 1999;173: 1603-1609.