Bedside Ultrasound vs X-Ray for the Diagnosis of Forearm Fractures in Children
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- 作者：Rachel Rowlands ; MBChB ; MRCPCH&lowast ; ; &dagger ; ; James Rippey ; MBBS ; FACEM&Dagger ; ; § ; ; Sing Tie ; MBBS ; FRACP&lowast ; ; &Dagger ; ; James Flynn ; MBBS ; FACEM&lowast ; ; § ; ; ‖ ;
- 关键词：pediatric forearm fractures ; ultrasound ; emergency physician ; x-ray study
- 刊名：The Journal of Emergency Medicine
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：52
- 期：2
- 页码：208-215
- 全文大小：353 K
- 卷排序：52
文摘
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.ObjectivesThe 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.MethodsA 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.ResultsAfter 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.ConclusionA 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.