The efficiency of bedside ultrasonography in patients with wrist injury and comparison with other radiological imaging methods: A prospective study

• Published in: The American journal of emergency medicine Vol. 35; no. 6; pp. 855 - 859
• Main Authors: Oguz, Ahmet Burak, Polat, Onur, Eneyli, Muge Gunalp, Gulunay, Behnan, Eksioglu, Merve, Gurler, Serdar
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2017; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bones; Computed tomography; Criteria; Cross-Sectional Studies; Emergency; Emergency medical care; Emergency medical services; Emergency Service, Hospital; Female; Filtration; Forearm; Fractures; Fractures, Bone - diagnostic imaging; Humans; Imaging methods; Injuries; Ligaments; Magnetic Resonance Imaging; Male; Medical imaging; Middle Aged; NMR; Nuclear magnetic resonance; Point-of-Care Systems - utilization; Predictive Value of Tests; Prospective Studies; Radiography; Radiology; Rheumatology; Scanning; Tendons; Tomography; Tomography, X-Ray Computed; Trauma; Turkey; Ultrasonography; Ultrasound; Wrist; Wrist Injuries - diagnostic imaging; Wrist injury; Young Adult; Wrist injury; Radiology; Trauma; Ultrasonography; Imaging methods
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2017.01.043

Abstract Study objective Our aim was to determine the efficiency of ultrasound (US) scanning in patients with wrist trauma admitted to the emergency department and to compare US diagnostic usage with other radiological imaging methods. Methods Patients who presented to the emergency department with wrist injury and who met the inclusion criteria and exclusion criteria were eligible. For all patients, US evaluation of the whole wrist was performed by an emergency physician before other radiological imaging methods (radiographies, computed tomography (CT) and magnetic resonance (MR) imaging). All of the patients included in the study underwent US, radiography, CT, and MR. Results During the study, 122 patients were admitted with a wrist injury. After filtering for the exclusion criteria, 80 patients were included in the study. The sensitivity of US scanning in detecting fractures was 95.31% (95% confidence interval [CI]: 87.1–98.39), the specificity was 93.75% (95% CI: 71.67–98.89), and the positive predictive value was 98.39% (95% CI: 91.72–99.85), and the negative predictive value was 83.33% (95% CI: 72.98–90.41). The sensitivity of US scanning in detecting tendon and ligamentous structural injury was 66.67% (95% CI: 41.71–84.82), the specificity was 100% (95% CI: 94.42–100), the positive predictive value was 100% (95% CI: 94.29–99.89), and the negative predictive was 92.86% (95% CI: 84.25–97.14). Conclusion US scanning is an effective method that can be applied in the emergency department to adult patients to diagnose distal forearm and carpal bones fractures. In soft tissue injuries, US and MR examinations produce similar results.