Evaluation by ultrasound of traumatic rib fractures missed by radiography
- 23 July 2010
- journal article
- Published by Springer Science and Business Media LLC in Emergency Radiology
- Vol. 17 (6), 473-477
- https://doi.org/10.1007/s10140-010-0892-9
Abstract
Rib fractures are the most common (25%) injuries resulting from blunt chest trauma, and are usually revealed on radiographs. Radiography sometimes cannot show fractures, especially those in costal cartilages, except for densely calcified ones. Several authors have recently investigated the role of ultrasound in the detection of rib fractures. We conducted this study to investigate possible rib fractures with ultrasound, determine those overlooked on chest x-ray, and analyze the possible clinical predictors of these insidious rib fractures in minor or mild blunt chest trauma. A total of 20 patients with minor mild blunt chest trauma were enrolled into this study. All radiographs were reviewed by two radiologists who noted rib fractures or other complications. Ultrasonography was performed in the radiology department using a linear transducer by one radiologist. The costal cartilage normally appears relatively hypoechoic compared with the osseous rib. Fractures of the rib, costochondral junction, and costal cartilage were denoted by a clear disruption of the anterior echogenic margin. A total of 20 patients with normal radiological findings, but continuing symptoms were evaluated by ultrasound. The most common etiology of trauma was a fall, as seen in 60% of the patients. None of the rib fractures were identified radiographically. Sonography detected 26 rib fractures in 18 of 20 subjects at presentation. Sonography reveals more fractures than radiography and will reveal fractures in most patients presenting with suspected rib fracture.Keywords
This publication has 18 references indexed in Scilit:
- High-Resolution Sonography of the Rib: Can Fracture and Metastasis Be Differentiated?American Journal of Roentgenology, 2005
- Is ultrasound really helpful in the detection of rib fractures?Injury, 2004
- Costal Cartilage Fractures as Revealed on CT and SonographyAmerican Journal of Roentgenology, 2001
- Sonography compared with radiography in revealing acute rib fracture.American Journal of Roentgenology, 1999
- Thoraxsonography—Part I: Chest wall and pleuraJapanese Journal of Clinical Oncology, 1997
- Ultraschalldiagnostik von Rippen- und SternumfrakturenUltraschall in der Medizin - European Journal of Ultrasound, 1997
- RIB FRACTURES IN MAJOR TRAUMAAnz Journal of Surgery, 1996
- Sonography: a simple way to visualize rib fractures.American Journal of Roentgenology, 1994
- Thoracic epidural in the management of chest traumaIntensive Care Medicine, 1985
- Radiographic evaluation of rib fracturesAmerican Journal of Roentgenology, 1982