Concordancia diagnóstica del ultrasonido versus Rayos X, para fracturas de huesos pequeños, Servicio de Emergencia del Hospital de los Valles, Cumbayá, 2015-2017

Augusto Maldonado, María López,Pablo Endara

Revista Ecuatoriana de Medicina EUGENIO ESPEJO(2019)

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摘要
Trauma of extremities are one of the main causes of morbidity in our setting. Ultrasound has emerged as a diagnostic tool due to its low cost, wide availability and minimal health risks. Exploration of muscles and bones with ultrasound is easy but demands specialized training for the interpretation of images. On the other side, classical Rx and Tomographic studies are costly and are riskier regarding negative health effects. Objective: This study aims to compare concordance between ultrasound and classical Rx approach in patients with suspected small bone fracture.Materials and Methods: This was a cross-sectional study that included forty-three consecutive patients admitted to the emergency department with suspected fractures of small limb bones due to trauma. They were evaluated by ultrasound and X-rays to establish their agreement. The final diagnosis of the presence or not of a fracture was established by a traumatologist. Results: Ultrasound performed better than X-rays and was able to detect an extra 26% more fractures. Concordance between both methods was moderate (73.7%), and Kappa index was 0.51, p-value: < 0.0002.Conclusions: Concordance between ultrasound and classical X-rays was moderate, this might be explained because ultrasound presented a higher capacity to detect fractures of small bones.
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