Ultrasonographic evaluation of costal cartilage fractures unnoticed by the conventional radiographic study and multidetector computed tomography

Lee, W. S.; Kim, Y. H.; Chee, Hyun Keun; Lee, Su A

doi:10.1007/s00068-011-0117-2

Cited by 25 publications

(28 citation statements)

References 18 publications

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“…LUS was reported to identify a higher proportion of patients with rib fractures than chest radiograph in 11 of the included studies 7 19 20 22–29. Furthermore, the use of LUS in the diagnosis of patients with rib fractures was reported superior to targeted, oblique rib radiographs in two studies7 28 and MDCT (in detection of costal cartilage fractures) in another study 19. The actual number of rib fractures identified by LUS compared with chest radiograph was also reported to be higher in four of the studies 24–27.…”

Section: Resultsmentioning

confidence: 98%

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Comparison of the use of lung ultrasound and chest radiography in the diagnosis of rib fractures: a systematic review

et al. 2018

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IntroductionIt is well-recognised that the detection of rib fractures is unreliable using chest radiograph. The aim of this systematic review was to investigate whether the use of lung ultrasound is superior in accuracy to chest radiography, in the diagnosis of rib fractures following blunt chest wall trauma.MethodsThe search filter was used for international online electronic databases including MEDLINE, EMBASE, Cochrane and ScienceDirect, with no imposed time or language limitations. Grey literature was searched. Two review authors completed study selection, data extraction and data synthesis/analysis process. Quality assessment using the Quality Assessment of Diagnostic Accuracy Studies Tool (QUADAS-2) was completed.Results13 studies were included. Overall, study results demonstrated that the use of lung ultrasound in the diagnosis of rib fractures in blunt chest wall trauma patients appears superior compared with chest radiograph. All studies were small, single centre and considered to be at risk of bias on quality assessment. Meta-analysis was not possible due to high levels of heterogeneity, lack of appropriate reference standard and poor study quality.DiscussionThe results demonstrate that lung ultrasound may be superior to chest radiography, but the low quality of the studies means that no definitive statement can be made.

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Section: Resultsmentioning

confidence: 98%

“…In terms of the use of the reference standard, one study used CT scan and chest radiograph,19 two used bone scintigraphy,20 26 one used chest radiograph22 and three used a repeat LUS21 23 25 at a later time point. Six of the studies failed to use a reference test at all 7 18 24 26 28 29.…”

Section: Resultsmentioning

confidence: 99%

Comparison of the use of lung ultrasound and chest radiography in the diagnosis of rib fractures: a systematic review

et al. 2018

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“…The causative factors responsible for isolated costal cartilage fractures could be aligned in two ways, either based on patient population or based on nature of injury (Table 1) [4]. Drivers and occupants were the most commonly affected population and traffic accident injury was the most common cause [4], whereas fist injury only accounted for 6.3% [4]. In general, isolated costal cartilage fractures often occur in the lower ribs and are typically caused by the direct impact from a blunt chest trauma [5].…”

Section: Discussionmentioning

confidence: 99%

“…Cartilage fractures are often located at the chondrocostal or chondrosternal junction for the first costal cartilages, while they occur at the mid-portion for other costal cartilages [6]. Subperiosteal haematoma was the most common finding associated with costal cartilage fractures (15.0%), followed by sternal fracture (9.7%) [4]. The first three costal cartilage fractures predispose to possible tracheal, bronchial and intrathoracic cardiovascular injuries [2].…”

Section: Discussionmentioning

confidence: 99%

Isolated costal cartilage fractures: the radiographically overlooked injuries

Yuan

2017

Folia Morphol

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“…In such cases, the patient would still complain of constant pain, which would lead the clinician to suspect malingering or would give cause for further confusion. Ultrasound examination is known to be more sensitive than plain chest radiography or CT in detecting such cartilage fractures (Lee et al, 2012). Furthermore, although plain chest radiography typically detects hemothorax at approximately 150 mL, ultrasound imaging can detect the condition with a volume as low as 40 mL, making it a highly sensitive diagnostic tool (Röthlin et al, 1993).…”

Section: Discussionmentioning

confidence: 99%

Simple X-ray versus ultrasonography examination in blunt chest trauma: effective tools of accurate diagnosis and considerations for rib fractures

Hwang¹,

Lee²

2016

J Exerc Rehabil

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Simple radiography is the best diagnostic tool for rib fractures caused by chest trauma, but it has some limitations. Thus, other tools are also being used. The aims of this study were to investigate the effectiveness of ultrasonography (US) for identifying rib fractures and to identify influencing factors of its effectiveness. Between October 2003 and August 2007, 201 patients with blunt chest trauma were available to undergo chest radiographic and US examinations for diagnosis of rib fractures. The two modalities were compared in terms of effectiveness based on simple radiographic readings and US examination results. We also investigated the factors that influenced the effectiveness of US examination. Rib fractures were detected on radiography in 69 patients (34.3%) but not in 132 patients. Rib fractures were diagnosed by using US examination in 160 patients (84.6%). Of the 132 patients who showed no rib fractures on radiography, 92 showed rib fractures on US. Among the 69 patients of rib fracture detected on radiography, 33 had additional rib fractures detected on US. Of the patients, 76 (37.8%) had identical radiographic and US results, and 125 (62.2%) had fractures detected on US that were previously undetected on radiography or additional fractures detected on US. Age, duration until US examination, and fracture location were not significant influencing factors. However, in the group without detected fractures on radiography, US showed a more significant effectiveness than in the group with detected fractures on radiography (P=0.003). US examination could detect unnoticed rib fractures on simple radiography. US examination is especially more effective in the group without detected fractures on radiography. More attention should be paid to patients with chest trauma who have no detected fractures on radiography.

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Ultrasonographic evaluation of costal cartilage fractures unnoticed by the conventional radiographic study and multidetector computed tomography

Cited by 25 publications

References 18 publications

Comparison of the use of lung ultrasound and chest radiography in the diagnosis of rib fractures: a systematic review

Comparison of the use of lung ultrasound and chest radiography in the diagnosis of rib fractures: a systematic review

Isolated costal cartilage fractures: the radiographically overlooked injuries

Simple X-ray versus ultrasonography examination in blunt chest trauma: effective tools of accurate diagnosis and considerations for rib fractures

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