Accuracy of Point-of-Care Ultrasonography for Pediatric Ankle Sprain Injuries

Pediatric Emergency Care
Sarah JonesKathy Boutis

Abstract

In children with radiograph fracture-negative lateral ankle injuries, the main objective of this pilot study was to explore the accuracy, sensitivity, and specificity of point-of-care ultrasound (POCUS) performed by a pediatric emergency physician in diagnosing anterior talofibular ligament injuries, radiographically occult distal fibular fractures, and effusions compared with reference standard magnetic resonance imaging (MRI). This was a prospective cohort pilot study. Children aged 5 to 17 years with an isolated, acute lateral ankle injury and fracture-negative ankle radiographs were eligible for enrolment. Within 1 week of the injury, enrolled children returned for MRI and POCUS of both ankles. Seven children were enrolled, with a mean age 12.1 (SD, 3.0) years. Overall, POCUS agreed with MRI with respect to anterior talofibular ligament injury in 4 (57%) of 7 cases. Of the 2 cases with MRI-confirmed ligament damage, POCUS accurately identified and graded the extent of ligament damage in 1 case. Point-of-care ultrasound falsely identified ligament injuries in 2 cases. Both imaging modalities confirmed the absence of cortical fractures in all 7 cases. For all findings, POCUS sensitivity and specificity were 57% and 86%, respe...Continue Reading

References

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Citations

Jun 13, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Sun Hwa Lee, Seong Jong Yun
Apr 4, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Apeksha ChaturvediNina B Klionsky

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