Ist die Sonografie der Röntgendiagnostik in der pädiatrischen Frakturdiagnostik gleichwertig?

Moritz, J.; Hoffmann, B.; Meuser, S. H.; Sehr, D; Caliebe, Amke; Heller, Martin

doi:10.1055/s-0029-1245371

Cited by 15 publications

(7 citation statements)

References 13 publications

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“…Erfolgt die sonografische Untersuchung wie empfohlen von ventral, dorsal, medial und lateral, kann auch die Dislokation zuverlässig erfasst werden [6]. Eine erforderliche Reposition kann mit einer Sensitivität von 100 % und einer Spezifität von 85-97 % identifiziert werden [3,5].…”

Section: Resultsunclassified

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Sonographic Fracture Diagnosis in Children and Adolescents

Moritz¹

2023

Rofo

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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: Zitierweise

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Section: Resultsunclassified

“…If the sonographic examination is performed as recommended in ventral, dorsal, medial, and lateral views, a dislocation can also be reliably detected [6]. The need for repositioning can be identified with a sensitivity of 100 % and a specificity of 85-97 % [3,5].…”

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confidence: 99%

Sonographic Fracture Diagnosis in Children and Adolescents

Moritz¹

2023

Rofo

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“…Dieses wichtige Thema schlägt sich in zahlreichen aktuellen und erfreulich oft zitierten Publikationen der RöFo nieder: Eindeutige Schwerpunkte der kinderradiologischen Arbeiten sind die Strahlenexposition [38 -41] und die Evaluation alternativer Bildgebungsmethoden [42]. Die höchsten Abrufzahlen bei den Online-Zugriffen zeigt hingegen ein Artikel mit hoher Relevanz für den klinisch-radiologischen Befundungsprozess, der eine neue systematische Schweregrad-Klassifikation bei der Osteogenesis imperfecta etabliert [43].…”

Section: Muskuloskelettales Systemunclassified

RöFo: Ausblick und Herausforderungen für die Zukunft

Heindel¹,

Schwindt²

2012

Fortschr Röntgenstr

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“…Radiography is an adequate imaging method for all uncomplicated fractures. In addition, good results can be achieved by ultrasound and in some cases radiological occult or missed fractures can be diagnosed (1-3). Some complex fractures, however, require additional imaging to clarify the exact location of the fracture line and the displacement.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Ultra-Low Dose CT in the Diagnosis of Pediatric-Like Fractures Using an Experimental Animal Study

et al. 2012

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ObjectiveThe aim of this prospective study was to evaluate the performance of ultra-low dose CT for the diagnosis of pediatric-like fractures and ascertain the lowest dose level sufficient for diagnostics.Materials and MethodsFifty-one bones of young pig cadavers were artificially fractured and subsequently examined by using a 64 multi-detector CT with 36 various dose levels down to a dose comparable with that of X-rays. Two pediatric radiologists analysed the CT scans according to the presence or absence of a fracture, determination of the fracture type and the displacement as well as the diagnostic certainty. For each dose protocol, a success rate for the correct determination of the above-mentioned CT analyses was calculated. A success rate of at least 95% was considered sufficient for diagnostics.ResultsAll but the lowest dose levels were sufficient to identify the fracture. Only the two lowest dose levels were insufficient to detect the fracture type. All dose levels were adequate for the identification of the displacement. The lowest dose level sufficient for diagnostics was 120 kVp, 11 mAs, and pitch 1.5, with a CTDIvol of 10% of a standard dose and an effective dose three times as large as that of X-rays.ConclusionUltra-low dose CT provides the feasibility of a significant dose reduction, still allowing sufficient diagnostics of pediatric-like fractures.

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Ist die Sonografie der Röntgendiagnostik in der pädiatrischen Frakturdiagnostik gleichwertig?

Cited by 15 publications

References 13 publications

Sonographic Fracture Diagnosis in Children and Adolescents

Sonographic Fracture Diagnosis in Children and Adolescents

RöFo: Ausblick und Herausforderungen für die Zukunft

Evaluation of Ultra-Low Dose CT in the Diagnosis of Pediatric-Like Fractures Using an Experimental Animal Study

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