Ultrasound detects forearm fractures in children no worse than a classic X-ray examination. This has been convincingly proved by Australian scientists.
The results of their research are published in the famous New England Journal of Medicine (NEJM).
X-ray made a fairy tale come true
When Wilhelm Roentgen discovered his all-penetrating X-rays, it was not just a scientific, but also a fantastic breakthrough. After all, he allowed to see through living organisms. We are accustomed to this, and it is difficult for us to understand how much this struck the contemporaries of the discovery. For medicine, the method became just a lifesaver and led to unprecedented progress in diagnosis, and then in treatment.
But today, we are not thinking more about the results of treatment, but about the harmfulness of research associated with radiation. Even with the simplest fracture, images should be taken twice, first to make a diagnosis, then to assess how the fracture has healed.
Habitual fracture and unusual diagnosis
And now a group of Australian scientists from several medical institutes and institutions compared classical x-rays and ultrasound to diagnose one of the most common fractures. This is a distal fracture of the forearm – in the part that is closer to the hand. In our country, it is usually called a fracture of the ray in a typical place (the ray is the radius, – ed.). It often occurs when falling in children who are fond of extreme sports – skateboard, snowboard, rollerblading, ice skating, etc. The arm can break when it is instinctively pulled forward to cushion the fall.
The study included 270 children aged 5-15 years, patients admitted to the emergency department with forearm injuries without bone displacement. Everyone was divided equally into two groups. Some were examined as usual – with the help of X-rays, and then treated depending on the specific diagnosis. In the other group, an ultrasound examination was performed first. If a fracture was found, an x-ray was taken to confirm. According to the conditions of the experiment, it was impossible to refuse such a “gold standard” of diagnostics. All children were contacted one, four and eight weeks after diagnosis to see how well their injuries were healing.
Ultrasound was not inferior to X-ray
Physicians did not find any differences in treatment outcomes between the two groups. If the children had not been given X-rays after an ultrasound examination to verify the diagnosis, then nothing would have changed. No fractures were missed on ultrasound. But there were pluses. Such diagnostics are not only safer, but also easier, faster, and cheaper. Moreover, today there are portable ultrasound machines and sensors that simply connect to a smartphone. And this means that it will soon be possible to diagnose fractures right on the spot, without taking the victim to the hospital.
It is clear that X-rays will not completely destroy this. After all, there are fractures that ultrasound will show poorly, or complex cases with displacement and fragments, when an x-ray is important for comparing fragments or performing an operation. But in the diagnosis of simple cases, and therefore the most frequent ones, after a while, X-ray machines can rest. Of course, this will not happen tomorrow. Medicine is a conservative discipline, and such innovations are introduced in it gradually and in stages.
Source: aif.ru
