The Accuracy of Bedside USG in the Diagnosis of Nasal Fractures

Am J Emerg Med. 2017 Nov;35(11):1653-1656. doi: 10.1016/j.ajem.2017.05.015. Epub 2017 May 18.


A comparison of the sensitivity and specificity of bedside ultrasonography with conventional radiography for the evaluation of nasal fractures.

Introduction - purpose: There is increasing use of ultrasonography in the Emergency Dept (ED) and other areas. The purpose of the present study was to evaluate the sensitivity and specificity of bedside ultrasonography with conventional radiographs in the evaluation of nasal fractures in the ED.

Method: Patients admitted to ED with maxillofacial trauma were evaluated in this prospective study. Ultrasonography scans of the patients were taken by the emergency physician at the bedside. The images were obtained from both laterals and parallel to the nasal dorsum. The nasal radiography scans were evaluated by an experienced radiologist blinded to the study. The ultrasonography and radiography results were compared statistically.

Results: The study included 103 patients. In showing the presence of nasal fracture, the sensitivity of ultrasonography was determined to be 84.8% (95% CI 71.13%-93.66%), specificity was 93.0% (95% CI 83.00%-98.05%), positive predictive value (PPV) was 90.7% (95% CI 77.86%-97.41%), negative predictive value (NPV) was 88.3% (95% CI 77.43%-95.18%).

Conclusion: Ultrasonography can be used in ED as an alternative method to conventional radiography with high rates of sensitivity and specificity in the evaluation of nasal fractures.

MeSH terms

  • Accidental Falls
  • Accidents, Traffic
  • Adolescent
  • Adult
  • Aged
  • Emergency Service, Hospital
  • Facial Injuries / diagnostic imaging*
  • Female
  • Fractures, Bone / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Nasal Bone / diagnostic imaging*
  • Nasal Bone / injuries
  • Point-of-Care Systems
  • Predictive Value of Tests
  • Prospective Studies
  • Radiography
  • Sensitivity and Specificity
  • Ultrasonography
  • Violence
  • Young Adult