Stellenwert der Sonographie in Traumatologie und Orthopädie

Abstract

Ultrasound examinations in trauma patients should be done in the emergency department using curved-array (3.5-7.5 MHz) probes. Blunt trauma of the abdomen and thorax must be regarded as a single organ injury. Sonography is the imaging technique of first choice and has completely replaced peritoneal lavage. Paramount advantages are its ability to provide rapid information and reproducible results at short intervals and in a noninvasive manner. The sensitivity and specificity of sonography in detecting intraabdominal fluid are 97-100% and 80-90%, respectively. To achieve such good results, though, adequate education in ultrasound and state-of-the-art devices is crucial. Clinical experiences prove that standardized sonography must be part of polytrauma management and should be integrated in advanced trauma life support courses. Technical improvements with better image quality and miniaturization of hardware will contribute to increase the use of this technique. However, ultrasound does not replace computed tomography for follow-up in answering more sophisticated questions in multiple injured patients.

The Diagnostic Value of Ultrasonography in Patients with Blunt Abdominal Trauma

“…According to previous studies, when it is available, it can be performed easily, is repeatable in short intervals, nonirradiating, inexpensive, noninvasive and able to provide rapid information, while US has low sensitivity in detection of solid organ injuries and overlooks significant damage (1,9,11,14).…”

“…Unexpected diagnoses are found by CT scans in the majority of patients. In haemodynamically stable patients, the diagnostic modality of choice is CT with intravenous contrast (11)(12)(13).…”