Sonographic diagnosis of toddler's fracture in the emergency department

Journal of Clinical Ultrasound : JCU
David Lewis, Peter Logan

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.

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Citations

Jan 17, 2016·Emergency Medicine Australasia : EMA·Andrew TaggBen Lawton
Mar 2, 2016·Pediatric Emergency Care·Afrah A W AliRobert J Hoffman
Jun 7, 2015·Journal of Forensic and Legal Medicine·Tracy A Pickett
Nov 7, 2016·The Journal of Emergency Medicine·Rachel RowlandsJames Flynn
Sep 24, 2018·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Antoine MorauxStefano Bianchi
May 14, 2008·Current Opinion in Pediatrics·Jason A Levy, Richard G Bachur
Aug 4, 2010·Physics in Medicine and Biology·Biren J ParmarRaffaella Righetti
Feb 1, 2017·Journal of Pediatric Orthopedics·Jennifer M Bauer, Steven A Lovejoy
Jan 1, 2014·Pediatric Emergency Care·Fred H WarkentineMary Clyde Pierce
Nov 5, 2016·Critical Ultrasound Journal·Jennifer R MarinResa E Lewiss
Jun 7, 2019·Journal of Pediatric Orthopedics·Jennifer M Bauer, Steven A Lovejoy
May 3, 2008·Pediatrics·Jason A Levy, Vicki E Noble

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