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Astaraki P, Baghchi B, Ahadi M. Diagnosis of acute nasal fractures using ultrasound and CT scan. Ann Med Surg (Lond) 2022; 78:103860. [PMID: 35734733 PMCID: PMC9207059 DOI: 10.1016/j.amsu.2022.103860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/21/2022] [Accepted: 05/22/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Nasal fractures need timely and accurate diagnosis for required treatment to prevent future deformities and unnecessary surgery. Radiography does not provide accurate finding in this case. The aim of this study is to evaluated diagnostic efficiency of ultrasound and CT scan for acute nasal fractures. Methods In this cross-sectional study included patients with nasal trauma referred to (XXX) from January 2020 to December 2020. Diagnostic ultrasound and CT scan was performed on all the patients and data obtained was stored in patient data collection forms along with their demographics. The data was statistically analyzed using SPSS v20. Results Of 32 patients included in our study, 4 (12.5%) were females and 28 (87.5%) were males. The mean age of the patients was 40.28 ± 16.9 years. The specificity and sensitivity of ultrasound was 100% and 83.33%. The accuracy of the test was 93.75%. The specificity, sensitivity and accuracy were 100%, 95% and 96.88%, respectively. Chi square test also showed that there were a significant association between nose fracture and both CT scan and ultrasound, p < 0.001. Conclusion Our study showed that both, ultrasound and CT scan are efficient for the diagnosis of nasal fractures in the patients. Further studies with greater sample size are required in this domain. Nasal fractures are one of the most common facial fractures due to trauma. Nasal fractures need timely and accurate diagnosis for required treatment to prevent future deformities. Ultrasound and CT scan are efficient for the diagnosis of nasal fractures in the patients. There were a significant association between nose fracture and both CT scan and Sonography.
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Pourmoosa R, Pourmoosa J, Taheri A, Khademloo M, Majidi H. Comparative evaluation of ultrasonography and lateral radiography in nasal fractures diagnosis. Am J Otolaryngol 2022; 43:103439. [PMID: 35405497 DOI: 10.1016/j.amjoto.2022.103439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/02/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Nasal fractures are the most common type of trauma fracture. Conventional radiography is the primary method of choice. Ultrasonography is used as a new and non-invasive method for this purpose. The aim of this study is to compare the diagnostic values of ultrasonography with nasal X-ray. METHODS This was a prospective study which was conducted during 2018-2019 at Bouali hospital, Sari, northern Iran. 130 patients who met our criteria enrolled our study. All patients underwent nasal X-ray and ultrasonography on a day of trauma. The physical examination during the reduction in operation room considered as gold standard for nasal bone fracture. The sensitivity, specificity, precision, positive predictive values, and negative predictive values, along with 95% confidence intervals, were determined by SPSS. RESULTS The sensitivity, specificity, positive predictive values, negative predictive values, and precision of nasal X-ray were all reported to be 100% when compared to physical examination (the gold standard). Ultrasonography had a sensitivity of 78.13%, a specificity of 100%, a PPV of 100%, an NPV of 61.82%, and a precision of 83.85% in comparison to physical examination (the gold standard). CONCLUSION The findings of this study suggest that ultrasonography can be utilized as a main diagnostic tool in the identification of nasal bone fractures in the vast majority of cases, avoiding the unwanted dangers and problems of X-rays. This is especially critical for expecting mothers and children.
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Rebours C, Glatre R, Plaisance P, Dohan A, Truchot J, Chauvin A. Diagnostic errors of nasal fractures in the emergency department: A monocentric retrospective study. World J Emerg Med 2022; 13:120-123. [PMID: 35237365 PMCID: PMC8861338 DOI: 10.5847/wjem.j.1920-8642.2022.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 10/12/2021] [Indexed: 04/16/2024] Open
Affiliation(s)
- Celeste Rebours
- Department of Ear Nose Throat-Head and Neck Surgery, Center Hospitalier Poissy-Saint Germaine en Laye, Poissy 78100, France
| | - Romain Glatre
- Department of Ear Nose Throat-Head and Neck Surgery, Center Hospitalier Poissy-Saint Germaine en Laye, Poissy 78100, France
| | - Patrick Plaisance
- Emergency Department, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Diderot University, Paris 75010, France
| | - Anthony Dohan
- Department of Radiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Sorbonne Paris Cité, Paris Descartes University, Paris 75014, France
- INSERM U965 CAP Paris-Tech: Carcinose Péritoine Paris technologique, Paris 75010, France
| | - Jennifer Truchot
- Emergency Department, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Diderot University, Paris 75010, France
| | - Anthony Chauvin
- Emergency Department, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Diderot University, Paris 75010, France
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel- Dieu Hospital, Paris 75001, France
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Chung JH, Yeo HD, Yoon ES, Lee BI, Park SH. Comparison of the Outcomes of Closed Reduction Nasal Bone Fractures With a Surgical Navigation System. J Craniofac Surg 2020; 31:1625-1628. [PMID: 32433134 DOI: 10.1097/scs.0000000000006546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The most prevalent form of facial bone fractures is nasal fractures. The surgical procedures used for these fractures are relatively simple, but complete correction is not easy because the nasal bone is small and identifying the fracture site by palpation is difficult. This study aimed to investigate the efficacy of intraoperative surgical navigation systems in nasal bone fracture surgery through a prospective analysis. METHODS Between February 2019 and July 2019, 25 navigation-assisted closed reductions of nasal fractures were performed. Preoperative computed tomography images were obtained at 1-mm intervals before surgery and the navigation was set by a simulation to have an error rate of less than 1. Then, the navigation system was used to identify the fracture site. Closed reduction was performed with Asch forceps and a Langenbeck elevator based on the previous markings made using the navigation system. RESULTS The degree of reduction was evaluated by plain X-rays and computed tomography scans, which were performed 1 month after surgery. In the navigation group, the average distance between the fragment and normal bony alignment was decreased from 2.38 to 0.49 mm and the modified Motomura score was an average of 2.40 points. The decrease in the mean distance was significantly different (P = 0.038) compared with the conventional group. CONCLUSIONS Surgical navigation systems could be a useful tool for localizing fracture sites and guiding closed reductions. In particular, the system could be recommended for nasal bone fracture reductions in the tip or pyriform regions, which are difficult to correct. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Jae-Ho Chung
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
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5
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Abstract
AIM The objective of this review was to determine the different types of surgical intervention in the management of nasal bone fractures, the outcomes, and complications associated with each intervention. METHODS A search was conducted using the PubMed and Cochrane Database of Systematic Review databases from January 1, 1997 until September 9, 2017. The search strategy was constructed using the Population Intervention Comparison Outcome framework with keywords related to nasal fracture and its treatment. Two sets of independent researchers performed the analysis. Qualitative analysis was performed using the Methodological Index for Non-Randomized Studies and National Institute for Clinical Excellence methodology for randomized controlled trial checklists. RESULTS The 4276 titles were obtained from PubMed database alone. Exclusion was made based on the title, abstract and full-text analysis. Finally, 23 papers were included and analyzed. Of the 23 papers, 13 (56.5%) were retrospective record review, 2 (8.7%) were randomized clinical trial or a randomized study and 8 case series (34.8%). 16 (69.6%) studies addressed closed reduction, 3 studies (13%) on open reduction and 4 studies (17.4%) addressed both open and closed reduction. The main focus in the outcome in all studies was accuracy of the anatomical reduction of the nasal bones. Three studies (13.0%) reported restoration of function such as breathing comfort or release in respiratory obstruction and another 3 (13.0%) addressed both cosmetic and breathing outcomes. Residual deformity was the most described complications in the studies (30.4%). In general, most of the studies were not of high quality as they lacked in some key elements in the Methodological Index for Non-Randomized Studies checklist. CONCLUSION Both closed and open reduction provided good outcomes in cosmetic and breathing. Septoplasty is recommended to be performed simultaneously with fracture reduction.
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Hwang K, Jung JS, Kim H. Diagnostic Performance of Plain Film, Ultrasonography, and Computed Tomography in Nasal Bone Fractures: A Systematic Review. Plast Surg (Oakv) 2018; 26:286-292. [PMID: 30450348 PMCID: PMC6236500 DOI: 10.1177/2292550317749535] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The aim of this study was to compare the diagnostic performance (accuracy, sensitivity, specificity, positive predictive value, and negative predictive value) of plain film (PF), ultrasonography (USG), and computed tomography (CT) in diagnosing nasal bone fractures (NBFs). METHODS In a search of PubMed and Scopus, "nasal bone fracture" AND "X-ray OR CT OR USG OR MRI" were searched. Among the 369 titles from PubMed and 379 titles from Scopus, 257 duplicate titles were excluded and 491 titles were reviewed. Among them, 36 full articles were reviewed. From these, 21 were excluded and 1 mined article was added; thus, 16 articles were reviewed. RESULTS The accuracy of CT (94.4% ± 2.3%) was significantly higher (P < .001) than that of USG (85.0% ± 3.6%). The accuracy of USG was significantly higher (P < .001) than that of PF (67.7% ± 4.7%). Computed tomography (89.3% ± 3.1%) and USG (87.2% ± 3.3%) were significantly more sensitive than PF (P < .001 and P < .001, respectively). The specificity of CT (94.2% ± 2.3%) was significantly higher (P = .001) than that of USG (87.4% ± 3.3%). The specificity of USG was significantly higher (P < .001) than that of PF (67.8% ± 4.7%). Among the PF techniques, combining a lateral view and the Water's view (71.8% ± 4.5%) had significantly higher accuracy than a lateral view alone (62.4% ± 4.8%) or the Water's view alone (61.0% ± 4.9%). In USG, there was no significant difference (P = .300) in accuracy among lateral and dorsal views (95.8% ± 2.0%), a lateral view alone (84.2% ± 3.7%), and a dorsal view alone (84.2% ± 3.6%). CONCLUSION The results of this review might be helpful in choosing the most appropriate diagnostic tool in patients suspected having NBF.
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Affiliation(s)
- Kun Hwang
- Department of Plastic Surgery, Inha University School of Medicine, Incheon, South Korea
| | - Joon Soo Jung
- Inha University School of Medicine, Incheon, South Korea
| | - Hun Kim
- Department of Plastic Surgery, Inha University School of Medicine, Incheon, South Korea
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Abstract
Nasal fractures are the most frequently fractured facial bone from blunt facial trauma resulting in a significant number of patients seeking treatment. Proper evaluation and treatment in the acute setting can minimize secondary surgeries, lower overall health care costs, and increase patient satisfaction. Nasal fracture management, however, varies widely between surgeons. The open treatment of isolated nasal fractures is a particularly controversial subject. This review seeks to describe the existing literature in isolated nasal fracture management.
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Tamada I, Mori T, Inoue N, Shido H, Aoki M, Nakamura Y, Kamogawa R. An Algorithmic Approach Using Ultrasonography in the Diagnosis of Pediatric Nasal Bone Fracture. J Craniofac Surg 2017; 28:84-87. [PMID: 27906845 DOI: 10.1097/scs.0000000000003217] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Ultrasonography (US) was recently reported as a reliable modality for diagnosing nasal bone fractures. However, whether US is reliable as a screening tool in the pediatric emergency department (ED) remains unknown. This prospective cohort study had a 2-fold aim: to assess the utility of US in the diagnosis of pediatric nasal bone fracture, and to evaluate the validity of our protocol for managing pediatric nasal bone fractures (Fuchu-Kids algorithm). PATIENTS AND METHODS Among the patients who presented at the ED with facial trauma, those with a suspected nasal bone fracture were enrolled in the study. Patients were treated according to Fuchu-Kids algorithm, and the validity of the protocol using US imaging was evaluated. RESULTS Among 81 patients who were enrolled during the 1-year study period, 63 patients were able to complete the process described in our protocol for further examination. The diagnostic power of the Fuchu-Kids algorithm had a sensitivity of 91.7%, a specificity of 92.3%, a positive predictive value (PPV) of 88%, and a negative predictive value (NPV) of 94.7%. However, when the performance of US was assessed as a single examination, its sensitivity, specificity, PPV, and NPV were 75%, 92.3%, 85.7%, and 85.7%, respectively. CONCLUSION Using our algorithm, the majority of patients with nasal bone fracture were successfully diagnosed and screened out successfully. Repeated US imaging is effective when clinical symptoms persist even if the first US imaging was negative for nasal bone fracture. However, a detailed medical interview and clinical examination are mandatory, regardless of the use of US.
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Affiliation(s)
- Ikkei Tamada
- *Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Children's Medical Center †Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
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Caglar B, Serin S, Akay S, Yilmaz G, Torun A, Adıbelli ZH, Parlak I. The accuracy of bedside USG in the diagnosis of nasal fractures. Am J Emerg Med 2017; 35:1653-1656. [PMID: 28552270 DOI: 10.1016/j.ajem.2017.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/12/2017] [Accepted: 05/13/2017] [Indexed: 10/19/2022] Open
Abstract
A comparison of the sensitivity and specificity of bedside ultrasonography with conventional radiography for the evaluation of nasal fractures. INTRODUCTION - PURPOSE There is increasing use of ultrasonography in the Emergency Dept (ED) and other areas. The purpose of the present study was to evaluate the sensitivity and specificity of bedside ultrasonography with conventional radiographs in the evaluation of nasal fractures in the ED. METHOD Patients admitted to ED with maxillofacial trauma were evaluated in this prospective study. Ultrasonography scans of the patients were taken by the emergency physician at the bedside. The images were obtained from both laterals and parallel to the nasal dorsum. The nasal radiography scans were evaluated by an experienced radiologist blinded to the study. The ultrasonography and radiography results were compared statistically. RESULTS The study included 103 patients. In showing the presence of nasal fracture, the sensitivity of ultrasonography was determined to be 84.8% (95% CI 71.13%-93.66%), specificity was 93.0% (95% CI 83.00%-98.05%), positive predictive value (PPV) was 90.7% (95% CI 77.86%-97.41%), negative predictive value (NPV) was 88.3% (95% CI 77.43%-95.18%). CONCLUSION Ultrasonography can be used in ED as an alternative method to conventional radiography with high rates of sensitivity and specificity in the evaluation of nasal fractures.
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Affiliation(s)
- Bahadır Caglar
- Emergency Medicine Clinic, Elazig Training and Research Hospital, Elazig, Turkey.
| | - Suha Serin
- Emergency Medicine Clinic, Urla City Hospital, Urla, Izmir, Turkey
| | - Serhat Akay
- Emergency Medicine Clinic, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Gokhan Yilmaz
- Emergency Medicine Clinic, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Alper Torun
- Emergency Medicine Clinic, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | | | - Ismet Parlak
- Emergency Medicine Clinic, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
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10
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Wang CC, Linden KL, Otero HJ. Sonographic Evaluation of Fractures in Children. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2017. [DOI: 10.1177/8756479316688897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fractures and suspected fractures are common causes for pediatric visits to the emergency department. Initial evaluation routinely includes imaging in the form of radiographs. Additional imaging modalities including sonography and magnetic resonance are used as problem-solving tools. Sonography has been reported to perform well when compared with radiography in multiple anatomies from the skull and nasal bones to the upper and lower extremities. In addition, sonography presents unique advantages including lack of ionizing radiation, cross-sectional coverage, evaluation of soft tissue injury, and the possibility of imaging the contralateral side. This article reviews the applications, advantages, disadvantages, technique, and performance of sonography in the imaging of fractures in children.
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Affiliation(s)
- Crystal C. Wang
- Children’s National Health System, Department of Diagnostic Imaging and Radiology, Washington, DC, USA
| | - Kadine L. Linden
- Children’s National Health System, Department of Diagnostic Imaging and Radiology, Washington, DC, USA
| | - Hansel J. Otero
- Children’s National Health System, Department of Diagnostic Imaging and Radiology, Washington, DC, USA
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Use of radiography and ultrasonography for nasal fracture identification in children under 18 years of age presenting to the ED. Am J Emerg Med 2016; 35:465-468. [PMID: 28043725 DOI: 10.1016/j.ajem.2016.11.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/22/2016] [Accepted: 11/28/2016] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To compare the diagnostic value of ultrasonography (USG), which is rapid, inexpensive, simple, and does not involve radiation, with that of direct radiography for identifying fractures in the nasal bones of pediatric patients presenting in the emergency department with nasal trauma. EQUIPMENT AND METHODS Patients under 18years old presenting with nasal trauma at the emergency department included prospectively. The patients' age and sex distribution, trauma type, GCS, physical examination findings, direct radiography, and USG results were recorded. The physical examination made by the emergency medicine specialist on arrival was accepted as the gold standard for diagnosis. FINDINGS In total, 133 patients, 34.6% female and 65.4% male, were included in this study. The average patient age was 7.44±5.05years, with the greatest proportion (21.8%, n=29) of patients in the age ranges of 0-2 and 6-8years. The most frequently observed finding on physical examinations was swelling (51.1%, n=68). In total, 50 (37.6%) patients had nasal fractures according to their first physical examination, which was performed by emergency medicine specialists. That is, fractures were detected by direct radiography in only 11 of the 34 cases who were diagnosed with fractures by USG. CONCLUSIONS We consider that USG should be preferred over direct radiography for use at the bedside of pediatric patients who present at emergency department with nasal trauma, because of its superior diagnostic ability and the lack of a requirement for radiation.
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Evirgen Ş, Kamburoğlu K. Review on the applications of ultrasonography in dentomaxillofacial region. World J Radiol 2016; 8:50-58. [PMID: 26834943 PMCID: PMC4731348 DOI: 10.4329/wjr.v8.i1.50] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/06/2015] [Accepted: 12/04/2015] [Indexed: 02/06/2023] Open
Abstract
Use of ultrasonography (US) in dentomaxillofacial region became popular in recent years owing to increasing radiation dose concerns and economic limitations. It helps to visualize fine detail of the surface structure of the oral and maxillofacial tissues without ionizing radiation. In diagnostic ultrasound, high frequency sound waves are transmitted into the body by a transducer and echoes from tissue interface are detected and displayed on a screen. Sound waves are emitted via piezoelectric crystals from the ultrasound transducer. US technique can be used in dentomaxillofacial region for the examination of bone and superficial soft tissue, detection of major salivary gland lesions, temporomandibular joint imaging, assessment of fractures and vascular lesions, lymph node examination, measurement of the thickness of muscles and visualization of vessels of the neck. It has the potential to be used in the evaluation of periapical lesions and follow up of periapical bone healing. Also, it may be used for the evaluation of periodontal pocket depth and for the determination of gingival thickness before dental implantology.
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Dallaudière B, Larbi A, Lefere M, Perozziello A, Hauger O, Pommerie F, Fraboulet B, Jacob D. Musculoskeletal injuries in a resource-constrained environment: comparing diagnostic accuracy of on-the-spot ultrasonography and conventional radiography for bone fracture screening during the Paris-Dakar rally raid. Acta Radiol Open 2015; 4:2058460115577566. [PMID: 26034643 PMCID: PMC4447636 DOI: 10.1177/2058460115577566] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 02/10/2015] [Indexed: 11/29/2022] Open
Abstract
Background Ultrasound (US) is a good first-line alternative for the diagnosis of bone fractures in adults as well as children. Our study shows that, compared to X-ray, in a resource-constrained environment, on-site US has a high sensitivity (98%) and specificity (96%) in the diagnosis of bone fractures. Purpose To compare the accuracy of on-the-spot US with conventional radiography in the screening for bone fractures during the Paris–Dakar rally raid. Material and Methods Eighty-three patients (81 men, 2 women) with clinically suspected bone fractures were included in 2013 and 2014. They underwent X-ray and US on the spot, blindly interpreted by two musculoskeletal radiologists. Using X-ray as gold standard, we calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US, for each anatomic location. The accuracy of US and radiography were also assessed, as were the number of fragments and their degree of displacement (Student’s t-test). Results Compared with X-ray, sensitivity, specificity, PPV, and NPV of on-site US were, respectively, for the presence (or absence) of fractures: 98%, 98%, 100%, and 95%. The accuracy of US was 99%. Only one radial styloid process fracture was misdiagnosed with US. There was no significant difference between US and X-ray (P > 0.93) concerning the number of fragments and their degree of displacement. Conclusion Bedside musculoskeletal ultrasound performed by trained musculoskeletal radiologists is a useful method in determining and assessing bone fractures in a resource constrained environment.
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Affiliation(s)
- Benjamin Dallaudière
- Hôpital Pellegrin, Service de Radiologie, Bordeaux, France ; Centre d'imagerie Ostéo-Articulaire, Clinique du sport de Bordeaux-Mérignac, Mérignac, France
| | - Ahmed Larbi
- Cliniques Universitaires Saint Luc, Service de Radiologie, Université Catholique de Louvain, Woluwe-Saint-Lambert, Belgium
| | - Mathieu Lefere
- Cliniques Universitaires Saint Luc, Service de Radiologie, Université Catholique de Louvain, Woluwe-Saint-Lambert, Belgium
| | - Anne Perozziello
- Biostatistic Department, Unité de recherche Clinique, Paris Nord, France
| | - Olivier Hauger
- Hôpital Pellegrin, Service de Radiologie, Bordeaux, France
| | | | | | - Denis Jacob
- Service de Radiologie, CHU Dijon, Dijon, France
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Ultrasonography in the diagnosis of nasal bone fractures: a comparison with conventional radiography and computed tomography. Eur Arch Otorhinolaryngol 2015; 273:413-8. [PMID: 25749616 DOI: 10.1007/s00405-015-3595-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to evaluate and compare the diagnostic efficacy of ultrasonography (US) with radiography and multi-detector computed tomography (CT) for the detection of nasal bone fractures. Forty-one patients with a nasal bone fracture who underwent prospective US examinations were included. Plain radiographs and CT images were obtained on the day of trauma. For US examinations, radiologist used a linear array transducer (L17-5 MHz) in 24 patients and hockey-stick probe (L15-7 MHz) in 17. The bony component of the nose was divided into three parts (right and left lateral nasal walls, and midline of nasal bone). Fracture detection by three modalities was subjected to analysis. Furthermore, findings made by each modality were compared with intraoperative findings. Nasal bone fractures were located in the right lateral wall (n = 28), midline of nasal bone (n = 31), or left lateral wall (n = 31). For right and left lateral nasal walls, CT had greater sensitivity and specificity than US or radiography, and better agreed with intraoperative findings. However, for midline fractures of nasal bone, US had higher specificity, positive predictive value, and negative predictive value than CT. Although two US evaluations showed good agreements at all three sites, US findings obtained by the hockey-stick probe showed closer agreement with intraoperative findings for both lateral nasal wall and midline of nasal bone. Although CT showed higher sensitivity and specificity than US or radiography, US found to be helpful for evaluating the midline of nasal bone. Furthermore, for US examinations of the nasal bone, a smaller probe and higher frequency may be required.
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