Is Ultrasound a Useful Tool for Detection of Nail Bed Injury?

Ultrasound was highly sensitive and specific for nail bed injury; however, injuries that do not involve the nail folds don't require repair anyway.

Subungual hematoma resulting from blunt trauma may be accompanied by laceration of the nail bed. Ascertaining the presence of a laceration requires removal of the nail, an invasive procedure. Investigators in Turkey studied the accuracy of point-of-care ultrasound for detection of nail bed injuries among 45 patients with trauma to a nail. The gold standard was nail removal and inspection of the nail bed, plus plain radiography to detect fractures.

Overall, 33 patients had nail bed injury and 16 had distal phalanx fracture. Ultrasound had a sensitivity of 93% and a specificity of 100% for detecting nail bed injury. For distal phalanx fracture, sensitivity was 100% and specificity was 98%.

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Is Ultrasound a Useful Tool for Detection of Nail Bed Injury?

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Reviewing Author