Sonographic diagnosis of toddler's fracture in the emergency department

J Clin Ultrasound. 2006 May;34(4):190-4. doi: 10.1002/jcu.20192.

Abstract

We describe 3 cases of toddler's fracture of the tibia that were diagnosed via sonographic examination. In cases, initial radiographs did not show the fracture, whereas sonographic examination revealed a layer of low reflectivity superficial to the tibial cortex and an elevated periosteum, suggesting a fracture hematoma. The diagnosis was confirmed at 2-3 weeks with radiographs demonstrating periosteal reaction. Both fractures were treated with cast immobilization for 4 weeks and made a full recovery. The third case was diagnosed via sonography and was confirmed by the initial radiographs. These results strongly suggest that sonography can detect the presence of a fracture hematoma and thus may help diagnose this injury earlier.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Emergency Medical Services
  • Female
  • Fractures, Bone / diagnosis*
  • Fractures, Bone / diagnostic imaging*
  • Humans
  • Infant
  • Male
  • Predictive Value of Tests
  • Radiography
  • Sensitivity and Specificity
  • Tibia / diagnostic imaging*
  • Ultrasonography