ED point-of-care ultrasound in the diagnosis of ankle fractures in children

In pediatric ankle injury, radiography is the current standard used to differentiate fracture from ligamentous injury; however, the associated cost, increased time, and radiation exposure pose a significant downside to this imaging modality. Point-of-care ultrasound may be an attractive alternative...

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Bibliographic Details
Published in:The American journal of emergency medicine 2012-09, Vol.30 (7), p.1328.e1-1328.e3
Main Authors: Taggart, Ian, Voskoboynik, Nika, MD, Shah, Sachita, MD, Liebmann, Otto, MD
Format: Article
Language:English
Subjects:
Adolescent
Ankle
Ankle Injuries - diagnostic imaging
Cost control
Emergency
Emergency medical care
Emergency medical services
Emergency Service, Hospital
Fibula - diagnostic imaging
Fibula - injuries
Fractures
Fractures, Bone - diagnostic imaging
Humans
Injuries
Male
Patient satisfaction
Pediatrics
Point of care testing
Point-of-Care Systems
Radiation
Radiography
Soccer - injuries
Tarsal Bones - diagnostic imaging
Tarsal Bones - injuries
Ultrasonic imaging
Ultrasonography
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Summary:In pediatric ankle injury, radiography is the current standard used to differentiate fracture from ligamentous injury; however, the associated cost, increased time, and radiation exposure pose a significant downside to this imaging modality. Point-of-care ultrasound may be an attractive alternative in this setting, as illustrated by this patient case. A 14-year-old boy presented to the emergency department with a left ankle inversion injury sustained while playing soccer. An emergency physician performed ultrasound examination that revealed findings consistent with a nondisplaced Salter-Harris I fracture of the distal fibula. The results of a formal radiograph confirmed this diagnosis. This case report presents the successful use of point-of-care ultrasound for detection of a Salter-Harris I ankle fracture, describes a stepwise approach for this new diagnostic technique in detail, and discusses its value in the setting of pediatric ankle injury.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2011.06.037