Ultrasound Evaluation of Skull Fractures in Children: A Feasibility Study
Pediatric Emergency Care, 05/07/2012
Riera A et al. – Bedside ultrasonography can be used by pediatric emergency medicine physicians to detect skull fractures in children with acute closed head injury (CHI).
This was a prospective, observational study conducted in a pediatric emergency department of an urban tertiary care children’s hospital.
A convenience sample of children younger than 18years were enrolled if they presented with an acute CHI, and a computed tomography (CT) scan was performed.
Ultrasound was performed by pediatric emergency medicine physicians with at least 1 month of training in bedside ultrasound.
Ultrasound interpretation as either positive or negative for the presence of skull fracture was compared with attending radiologist CT scan dictation.
Test characteristics (sensitivity, specificity, and positive and negative predictive values) were calculated.
Forty–six patients were enrolled.
The median age was 2years (range, 2months to 17years).
Eleven patients (24%) were diagnosed with skull fractures on CT scan.
Bedside ultrasound had a sensitivity of 82% (95% confidence interval [CI], 48%–97%), specificity of 94% (95% CI, 79%–99%), positive predictive value of 82% (95% CI, 48%–97%), and negative predictive value of 94% (95% CI, 79%–99%).
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