TY - JOUR
T1 - Bedside ultrasound vs x-ray for the diagnosis of forearm fractures in children
AU - Rowlands, Rachel
AU - Rippey, James
AU - Tie, Sing
AU - Flynn, James
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Background Painful forearm injuries after a fall occur frequently in children. X-ray study is currently the gold standard investigation. Ultrasound (US) is a potential alternative that avoids exposure to ionizing radiation and may be less painful than x-ray study; and familiarity and skill with US is increasing among emergency physicians. Objectives The primary aim of this study was to determine if a cohort of physicians with little or no previous experience with US could, after a short training program, safely exclude forearm fractures in children. Secondary aims were to compare any pain or discomfort associated with clinical examination, US, and x-ray study and to determine the acceptability of US as a diagnostic tool to parents and patients. Methods A prospective, nonrandomized, interventional diagnostic study was performed on children between the ages of 0 and 16 years who had a suspected fracture of the forearm. US scanning was performed by a group of physicians, most with little or no previous US experience. Results After the brief training program, a group of pediatric emergency physicians could diagnose forearm fractures in children with a sensitivity of 91.5% and a specificity of 87.6%. Pain associated with US was no better or worse than pain associated with x-ray study. Patients and parents preferred US over x-ray study as an investigation modality for suspected forearm fractures. Conclusion A group of pediatric emergency physicians with limited previous experience could, after a short training program, diagnose forearm fractures in children. Pain associated with US was no better or worse than pain associated with x-ray study.
AB - Background Painful forearm injuries after a fall occur frequently in children. X-ray study is currently the gold standard investigation. Ultrasound (US) is a potential alternative that avoids exposure to ionizing radiation and may be less painful than x-ray study; and familiarity and skill with US is increasing among emergency physicians. Objectives The primary aim of this study was to determine if a cohort of physicians with little or no previous experience with US could, after a short training program, safely exclude forearm fractures in children. Secondary aims were to compare any pain or discomfort associated with clinical examination, US, and x-ray study and to determine the acceptability of US as a diagnostic tool to parents and patients. Methods A prospective, nonrandomized, interventional diagnostic study was performed on children between the ages of 0 and 16 years who had a suspected fracture of the forearm. US scanning was performed by a group of physicians, most with little or no previous US experience. Results After the brief training program, a group of pediatric emergency physicians could diagnose forearm fractures in children with a sensitivity of 91.5% and a specificity of 87.6%. Pain associated with US was no better or worse than pain associated with x-ray study. Patients and parents preferred US over x-ray study as an investigation modality for suspected forearm fractures. Conclusion A group of pediatric emergency physicians with limited previous experience could, after a short training program, diagnose forearm fractures in children. Pain associated with US was no better or worse than pain associated with x-ray study.
KW - emergency physician
KW - pediatric forearm fractures
KW - ultrasound
KW - x-ray study
UR - http://www.scopus.com/inward/record.url?scp=85004088939&partnerID=8YFLogxK
U2 - 10.1016/j.jemermed.2016.10.013
DO - 10.1016/j.jemermed.2016.10.013
M3 - Article
C2 - 27814988
AN - SCOPUS:85004088939
SN - 0736-4679
VL - 52
SP - 208
EP - 215
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 2
ER -