Ultrasound Performs Well, but Is Impractical for Identifying Pediatric Elbow Fractures

Point-of-care ultrasound was 98% sensitive and 70% specific for identifying pediatric elbow fractures, but radiographs are still needed to guide management.

In a prospective, observational study of patients (age, <21 years) presenting to a pediatric emergency department with elbow injuries, investigators evaluated point-of-care ultrasonography for identifying lipohemarthrosis (elevation of the posterior fat pad) as a marker for fracture. Pediatric emergency medicine attending physicians and fellows participated in a 30-minute didactic session followed by a 30-minute hands-on practical session with live models. Ultrasound was performed using a linear probe with the elbow flexed at 90 degrees, and the posterior aspect of the distal humerus was imaged on longitudinal and transverse views.

Of 130 patients (mean age, 7.5 years), 43 had fractures identified on plain radiographs; of these, 38 were iden…

Reviewing Author

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)