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Rofo 2023; 195(09): 790-796
DOI: 10.1055/a-2042-2161
Review

Sonographic Fracture Diagnosis in Children and Adolescents

Article in several languages: English | deutsch
Jörg Detlev Moritz
  Radiology and Neuroradiology, Pediatric Radiology, UK-SH, Campus Kiel, Germany
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Abstract

Background Clinical examination after trauma, especially in young children, often proves difficult. As a result, the majority of images show unremarkable findings in the imaging workup of trauma by radiography. Sonography represents an imaging technique without the use of X-rays. As the quality of ultrasound equipment has increased over the past 20 years, numerous studies have demonstrated that fractures in children and adolescents can be detected with very high sensitivity and specificity by sonography.

Method This paper reviews the results obtained so far in the literature. Based on these findings, the importance of sonographic fracture diagnosis in childhood and adolescence for the most important locations is demonstrated.

Results When examining with a high-frequency linear transducer, sensitivities and specificities of more than 90 % can be achieved for the detection of fractures. Dislocations are also reliably detected. In contrast to X-ray examination, sonography allows the diagnosis of cartilage and soft-tissue injuries. Sonography reveals callus formation earlier than radiographs. The examination causes less pain than X-ray examination. If sonographic clarification is limited purely to fracture detection or exclusion, less time is required compared to X-ray diagnosis. The procedure can be learned quickly. If the documentation follows a defined standard examination procedure, the results can also be reproduced by non-examiners.

Conclusion So far, sonography has only been an additive procedure in fracture diagnosis. However, there are now initial recommendations for sonographic fracture diagnosis alone, such as in skull, clavicle and non-displaced distal forearm fractures.

Key Points:

  • Sonography can be used to detect or rule out fractures very sensitively.

  • Sonographic examination causes less pain than X-ray examination.

  • Sonography is usually an additive procedure in fracture diagnosis.

  • In the meantime, sonography alone may be sufficient for diagnosing individual fractures.

Zitierweise

  • Moritz JD. Sonografische Frakturdiagnostik im Kindes- und Jugendalter. Fortschr Röntgenstr 2023; 195: 790 – 796

Key words

ultrasound - bones - children, injuries - infants, injuries - trauma


Publication History

Received: 28 December 2022

Accepted: 24 January 2023

Article published online:
26 April 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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