Ultrasound Secondary Signs for the Diagnosis of Pediatric Distal Forearm Fractures: A Diagnostic Study

被引：0
|
作者：
Snelling, Peter J. [1 ,2 ,3 ,4 ]
Jones, Philip [1 ,2 ,3 ,5 ]
Bade, David [1 ,6 ]
Gillespie, Alan [2 ]
Keijzers, Gerben [1 ,2 ,3 ,7 ]
Ware, Robert S. [1 ,3 ]
机构：
[1] School of Medicine and Dentistry, Griffith University, Southport,QLD, Australia
[2] Department of Emergency Medicine, Gold Coast University Hospital, Southport,QLD, Australia
[3] Sonography Innovation and Research (Sonar) Group, QLD, Australia
[4] Child Health Research Centre, University of Queensland, Brisbane,QLD, Australia
[5] Department of Emergency Medicine, Logan Hospital, Meadowbrook,QLD, Australia
[6] Department of Orthopaedics, Queensland Children's Hospital, South Brisbane,QLD, Australia
[7] Faculty of Health Sciences and Medicine, Bond University, Gold Coast,QLD, Australia
来源：
Ultrasound in Medicine and Biology | 2024年 / 50卷 / 06期
关键词：
Objective: To evaluate the diagnostic accuracy of ultrasound secondary signs of fractures in pediatric patients aged 5–15 y presenting to the emergency department with a clinically non-deformed distal forearm injury. Methods: This diagnostic study was conducted in South East Queensland; Australia. Emergency clinicians performed point-of-care ultrasound on eligible patients and recorded secondary signs of fractures (pronator quadratus hematoma [PQH] sign; periosteal hematoma; visible angulation) or physeal fractures (fracture-to-physis distance [FPD; physis alteration). The reference standard was the final fracture diagnosis determined by expert panel. The primary outcome was the diagnostic accuracy of secondary signs for cortical breach and physeal fractures. Diagnostic statistics were reported for each relevant secondary sign. Results: A total of 135 participants were enrolled. The expert panel diagnosed 48 no fracture; 52 buckle fracture and 35 other fracture. All other fractures were cortical breach fractures and included 15 Salter–Harris II fractures. The PQH sign demonstrated high sensitivity and moderate specificity to diagnose cortical breach fractures (91%; 95% Confidence Interval [CI] 78%–97% and 82%; 73%–88%). Poor sensitivity but high specificity was observed for the visible angulation and periosteal hematoma secondary signs. FPD © 2024 The Authors;
D O I：
10.1016/j.ultrasmedbio.2024.02.015
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页码：898 / 907
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