Title: Diagnostic performance of Ultrasound for detection of pediatric elbow fractures<br/>Author: Brian Corwell<br/><a href='http://umem.org/profiles/faculty/294/'>[Click to email author]</a><hr/><p> <strong>Diagnostic performance of Ultrasonography for detection of pediatric elbow fracture</strong></p> <p> Elbow fractures account for approximately 15% of pediatric fractures</p> <p> Fat pads are traditionally taught as a marker of fracture</p> <p> <strong>In a cadaveric study:</strong></p> <p> Elbow effusions of 1-3 mL could be identified with ultrasound</p> <p> Elbow effusions of 5-10 mL could be identified with plain film</p> <p> Pediatric plain films are sometimes challenging to obtain and interpret compared to adults</p> <p> -More likely to be uncooperative in obtaining required views</p> <p> -Non-ossified epiphyses</p> <p> Ultrasound may be used to detect</p> <p> -Cortical disruption and irregularity</p> <p> -Growth plate widening</p> <p> -Hematoma interposed between fracture fragments</p> <p> -Elevated posterior fat pad</p> <p> Absence of elbow fracture was indicated by</p> <p> -Lack of cortical disruption</p> <p> -Absence of posterior fat pad sign</p> <p> <strong>Meta-analysis of 10 articles totaling 519 patients using ultrasonography to detect elbow fractures</strong></p> <p> <span style="background-color:#ffff00;"> Sensitivity 96%</span></p> <p> <span style="background-color:#ffff00;"> Specificity 89%</span></p> <p> <span style="background-color:#ffff00;"> False negative rate 3.7% </span></p> <p> <strong>For comparison, plain radiographs</strong></p> <p> Interpreted by peds EM physicians (87.5% sensitive and 100% specific)</p> <p> Interpreted by radiology (96% sensitive, 100% specific)</p> <p> </p> <p> <strong>Consider using ultrasound as a noninvasive, radiation-free modality for accurate diagnosis of pediatric elbow fractures.</strong></p> <p> </p> <fieldset><legend>References</legend>
<p> <span style="color: rgb(33, 33, 33); font-family: BlinkMacSystemFont, -apple-system, "Segoe UI", Roboto, Oxygen, Ubuntu, Cantarell, "Fira Sans", "Droid Sans", "Helvetica Neue", sans-serif; font-size: 16px;">Lee SH, Yun SJ. Diagnostic Performance of Ultrasonography for Detection of Pediatric Elbow Fracture: A Meta-analysis. </span><i style="box-sizing: inherit; color: rgb(33, 33, 33); font-family: BlinkMacSystemFont, -apple-system, "Segoe UI", Roboto, Oxygen, Ubuntu, Cantarell, "Fira Sans", "Droid Sans", "Helvetica Neue", sans-serif; font-size: 16px;">Ann Emerg Med</i><span style="color: rgb(33, 33, 33); font-family: BlinkMacSystemFont, -apple-system, "Segoe UI", Roboto, Oxygen, Ubuntu, Cantarell, "Fira Sans", "Droid Sans", "Helvetica Neue", sans-serif; font-size: 16px;">. 2019;74(4):493-502.</span></p> </fieldset>