The accuracy of point-of-care ultrasound as a diagnostic tool for patella fractures

Kılıç, Turgay Yılmaz; Yeşilaras, Murat; Atilla, Özge Duman; Turgut, Ali

doi:10.1016/j.ajem.2016.05.073

Cited by 7 publications

(11 citation statements)

References 11 publications

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“…These varied considerably in sample size, from 15 to 260 subjects, and consisted of participants recruited consecutively upon presentation to the Emergency Department, with the exception of Dallaudière et al, who conducted their research in a prehospital setting [27], and two papers which recruited participants from specialist units, namely hand surgery [12] and rheumatology [22]. The largest bulk of evidence was produced by research conducted in Turkey [13, 19, 26, 28–33] and other Middle-Eastern countries such as Iran [34, 35] and Israel [24], with the remaining 14 studies spread across continental Europe and the Americas.…”

Section: Resultsmentioning

confidence: 99%

“…Other specific injury sites included fractures of the foot and ankle [13, 28, 31, 37, 38], including metatarsal stress fractures [22] and Hill-Sachs injuries [18, 39]. The remaining eight studies focussed on a heterogeneous mixture of upper and lower limb fractures [27, 34] involving the radius and/or ulna [26, 40], humerus and/or femur [25, 41], hip [24] and patella [19].…”

Section: Resultsmentioning

confidence: 99%

“…All included studies enrolled patients consecutively, with most using a convenience sampling design – that is, patients meeting the inclusion criteria were recruited within the specified time period if a researcher or sonographer was present at the time of patient presentation to hospital [19–21, 25, 28, 30–33, 36–38, 41]. Despite randomising patient selection in order to minimize researcher influence, this method of sampling may introduce some degree of selection bias if certain characteristics are overrepresented in patients presenting to hospital between specific working hours.…”

Section: Resultsmentioning

confidence: 99%

“…Standard radiography was employed as the reference standard for, and has a high sensitivity for diagnosing, fractures of the hand/arm [25, 26, 29, 30, 32, 33, 35, 36, 40], patella [19] and foot/ankle [13, 28, 31, 37, 38], with the exception of metatarsal stress fractures, which are usually radiologically occult at onset [22]. However, Banal et al avoided introducing bias into their investigation of this fracture type by utilising MRI, which is a highly sensitive modality for the diagnosis of stress fractures [22].…”

Section: Resultsmentioning

confidence: 99%

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The effectiveness of ultrasound in the detection of fractures in adults with suspected upper or lower limb injury: a systematic review and subgroup meta-analysis

et al. 2019

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BackgroundThe aim of the present review is to assess the effectiveness of ultrasound (US) in the detection of upper and lower limb bone fractures in adults compared to a diagnostic gold standard available in secondary and tertiary care centres (e.g. radiography, CT scan or MRI).MethodsThe review followed PRISMA guidelines and used a database-specific search strategy with Medline, EMBASE and The Cochrane Library plus secondary sources (see supplementary material for completed PRISMA checklist). Diagnostic performance of ultrasound was assessed with a qualitative synthesis and a meta-analysis of two data subgroups.ResultsTwenty-six studies were included (n = 2360; fracture prevalence =5.3 % to 75.0%); data were organised into anatomical subgroups, two of which were subjected to meta-analysis. Sensitivity and specificity ranged from 42.11 − 100% and 65.0 − 100%, with the highest diagnostic accuracy in fractures of the foot and ankle. The pooled sensitivity and specificity of US was 0.93 and 0.92 for upper limb fractures (I2 = 54.7 % ; 66.3%), and 0.83 and 0.93 for lower limb fractures (I2 = 90.1 % ; 83.5%).ConclusionUltrasonography demonstrates good diagnostic accuracy in the detection of upper and lower limb bone fractures in adults, especially in fractures of the foot and ankle. This is supported by pooled analysis of upper and lower limb fracture subgroups. Further research in larger populations is necessary to validate and strengthen the quality of the available evidence prior to recommending US as a first-line imaging modality for prehospital use.Trial registrationThe protocol is registered with the PROSPERO International register of systematic reviews: ID = CRD42017053640.Electronic supplementary materialThe online version of this article (10.1186/s12873-019-0226-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The effectiveness of ultrasound in the detection of fractures in adults with suspected upper or lower limb injury: a systematic review and subgroup meta-analysis

et al. 2019

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“…). At full text nine primary articles, 28 systematic review (SR) articles and 18 guidelines were included.…”

Section: Resultsmentioning

confidence: 99%

Review article: Best practice management of common knee injuries in the emergency department (part 3 of the musculoskeletal injuries rapid review series)

Strudwick

McPhee

Bell

et al. 2017

Emerg Medicine Australasia

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Knee injuries are a common presentation to the ED and are often difficult to assess and definitively diagnose due to the patient's acute pain, effusion and guarding. The quality of ED care provided to patients with fractures or soft tissue injuries of the knee is critical to ensure the best possible outcomes for the patient. This rapid review investigated best practice for the assessment and management of common knee injuries in the ED. Databases were searched in 2017, including PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites. Primary studies, systematic reviews and guidelines were considered for inclusion. English-language articles published in the past 12 years that addressed the acute assessment, management, follow-up plan or prognosis were included. Data extraction of included articles was conducted, followed by quality appraisal to rate the level of evidence where possible. The search revealed 2250 articles, of which 54 were included in the review (n = 8 primary articles, n = 28 systematic reviews, n = 18 guidelines). This rapid review provides clinicians managing fractures and soft tissue injuries of the knee in the ED, a summary of the best available evidence to enhance the quality of care for optimal patient outcomes. There is consistent evidence to support undertaking a thorough history and physical examination, including the application of special tests and clinical decision rules for imaging. In the undifferentiated knee injury, expedited follow up and further imaging is recommended to improve patient outcomes and cost-effectiveness.

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Comparison of diagnostic accuracy of point-of-care ultrasonography and X-ray of bony injuries of the knee

Kozacı

Avcı

Yüksel³

et al. 2022

Eur J Trauma Emerg Surg

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The accuracy of point-of-care ultrasound as a diagnostic tool for patella fractures

Cited by 7 publications

References 11 publications

The effectiveness of ultrasound in the detection of fractures in adults with suspected upper or lower limb injury: a systematic review and subgroup meta-analysis

The effectiveness of ultrasound in the detection of fractures in adults with suspected upper or lower limb injury: a systematic review and subgroup meta-analysis

Review article: Best practice management of common knee injuries in the emergency department (part 3 of the musculoskeletal injuries rapid review series)

Comparison of diagnostic accuracy of point-of-care ultrasonography and X-ray of bony injuries of the knee

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