Comparing Ultrasonography With Plain Radiography in the Diagnosis of Long Bone Fractures

Objective: This study was designed to compare sonography to skeletal radiography, in the diagnosis of long bone fractures. Materials and Methods: This was a cross-sectional and analytical study including 188 patients of varied ages that had 251 suspected long bone fractures. It was conducted over a 9-month period, in the emergency department of a teaching hospital, within the Swat district of Pakistan. After assessing the clinical symptoms of the fracture by an emergency orthopedic physician, sonography was followed by a radiograph performed for these referred patients. Results: Sonography shows a diagnostic accuracy of 91.23% for detecting long bone fractures, with a sensitivity and specificity of 100% and 76.84%, respectively. The positive predictive value and negative predictive value were 87.64% and 100%, respectively. Sonography was able to detect small fractures (up to 0.23 mm) that are often missed on the patient’s radiograph. Conclusion: Sonography may be useful as an initial screening imaging technique for the diagnosis of long bone fractures. The potential exists to reduce the need for unnecessary skeletal radiographs, which could reduce treatment time, cost, and ionizing radiation hazards.