Goal-directed ultrasound in the detection of long-bone fractures

J Trauma. 2004 Aug;57(2):329-32. doi: 10.1097/01.ta.0000088005.35520.cb.


Background: New portable ultrasound (US) systems are capable of detecting fractures in the remote setting. However, the accuracy of ultrasound by physicians with minimal ultrasound training is unknown.

Methods: After one hour of standardized training, physicians with minimal US experience clinically evaluated patients presenting with pain and trauma to the upper arm or leg. The investigators then performed a long-bone US evaluation, recording their impression of fracture presence or absence. Results of the examination were compared with routine plain or computer aided radiography (CT).

Results: 58 patients were examined. The sensitivity and specificity of US were 92.9% and 83.3%, and of the physical examination were 78.6% and 90.0%, respectively. US provided improved sensitivity with less specificity compared with physical examination in the detection of fractures in long bones.

Conclusion: Ultrasound scans by minimally trained clinicians may be used to rule out a long-bone fracture in patients with a medium to low probability of fracture.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Competence / standards
  • Education, Medical, Continuing / standards
  • Emergency Medicine / education
  • Emergency Medicine / standards
  • Emergency Service, Hospital
  • False Negative Reactions
  • False Positive Reactions
  • Femoral Fractures / diagnostic imaging*
  • Hospitals, Teaching
  • Humans
  • Humeral Fractures / diagnostic imaging*
  • Mass Screening / methods
  • Mass Screening / standards
  • Medical Staff, Hospital / education
  • Medical Staff, Hospital / standards
  • Middle Aged
  • Patient Selection
  • Physical Examination / standards
  • Point-of-Care Systems / standards*
  • Prospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / standards
  • Ultrasonography / instrumentation
  • Ultrasonography / methods
  • Ultrasonography / standards