Ultrasound Waves Could Help Diagnose Minor Fractures

A new study reveals that most patients with a minor fracture had injuries that could be detected through ultrasonography (US).

Researchers at Cirencester Hospital (United Kingdom) conducted a study of the usefulness and efficiency of portable US in detecting the presence of minor fractures in patients presenting to the minor injuries unit (MIU). Over a 12 month period, 97 patients with suspected minor fractures who volunteered to participate in the study underwent clinical assessments of suspected limb fractures where the skin was not broken (closed fractures). The patients were referred to X-ray, but also for US imaging of their injured area.

The results showed that 60 patients (62%) had fractures confirmed by normal routine X-ray assessment. Analysis showed that 51 of these patients (85%) had injuries detected through US as well. In arm fractures, US picked up on 87% of the confirmed fractures in 24 patients. The authors claimed that using US would reduce exposure to radiation, as well as providing an alternative when radiology units are closed. It would also allow comparison of right and left limbs without irradiation concerns. The study was published in the May 2015 issue of Emergency Nurse Journal.

“The study suggests that ultrasonography is a reliable way to detect fractures of the distal radius or ulna, and it is reasonable to conclude that portable ultrasound devices will play an increasingly significant role in the assessment of patients with suspected minor or even subtle fractures in emergency care settings,” concluded study authors Salam Musa, MD, and Paul Wilson, MD, of Cirencester Hospital MIU, adding that “the study demonstrates that emergency clinicians can rule in fractures by studying ultrasound images but ruling out fractures is still the job of radiologists.”

Point-of-care US equipment is compact, portable, and less costly than X-ray systems. The modality is highly specific for identifying fractures as small as one mm, due to the reflective acoustic properties of cortical bone. In poor countries and geographically remote locations lacking X-ray equipment, point-of-care ultrasound by physicians minimally trained in its use may produce diagnostic images that can greatly benefit diagnosis.

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