Diagnostic Accuracy of Ultrasonography in Diagnosis of Metatarsal Bone Fracture; a Cross Sectional Study
Archives of Academic Emergency Medicine,
Vol. 7 No. 1 (2019),
Introduction: Metatarsus is one of the most common sites in the sole of foot bones fractures. The aim of this study was to determine the diagnostic accuracy of ultrasound in diagnosis of metatarsal bone fractures following foot trauma.
Methods: This cross-sectional study was carried out on patients with blunt foot trauma admitted to emergency department of a hospital in Mashhad, Iran from January to September 2016. All patients were evaluated with bedside ultrasound for the presence of first to fifth metatarsal fractures and screening performance characteristics of ultrasonography in detection of metatarsal fractures were calculated considering foot radiography as the reference test.
Results: The study was conducted on 102 patients with a mean age of 35.14Â±14.32 years (56.8% male). The most common signs of trauma in physical examination were pain and tenderness (100%), swelling (96.1%), ecchymosis (14.7%) and deformity (1.9%). Sensitivity, specificity, and positive and negative likelihood ratio of ultrasonography in detection of metatarsal bone fracture were 96.7% (95% CI: 0.83-0.99), 84.5% (95% CI: 0.73-0.92), 73.1% (95% CI: 0.57-0.85), and 98.3% (95% CI: 0.91-0.99), respectively. The overall accuracy of ultrasonography was 0.906 (95% CI: 0.844 â€“ 0.969) based on area under the receiver operating characteristic (ROC) curve.
Conclusion: Considering the excellent diagnostic accuracy, ultrasonography can be used as an alternative means in diagnosis of metatarsal bone fractures.
- metatarsal bones
How to Cite
English E. Fractures and soft tissue injuries of the feet and ankle. Canadian family physician Medecin de famille canadien. 1985 Mar;31:585-90. PubMed PMID: 21274230. Pubmed Central PMCID: PMC2327960. Epub 1985/03/01. eng.
Canagasabey MD, Callaghan MJ, Carley S. The sonographic Ottawa Foot and Ankle Rules study (the SOFAR study). Emergency medicine journal : EMJ. 2011 Oct;28(10):838-40. PubMed PMID: 20943841. Epub 2010/10/15. eng.
Hedelin H, GoksÃ¶r L-Ã…, Karlsson J, StjernstrÃ¶m S. Ultrasound-assisted triage of ankle trauma can decrease the need for radiographic imaging. The American Journal of Emergency Medicine. 2013 2013/12/01/;31(12):1686-9.
Banal F, Gandjbakhch F, Foltz V, Goldcher A, Etchepare F, Rozenberg S, et al. Sensitivity and Specificity of Ultrasonography in Early Diagnosis of Metatarsal Bone Stress Fractures: A Pilot Study of 37 Patients. The Journal of Rheumatology. 2009;36(8):1715.
Drakonaki EE, Garbi A. Metatarsal Stress Fracture Diagnosed With High-Resolution Sonography. Journal of Ultrasound in Medicine. 2010 2010/03/01;29(3):473-6.
Wang C-L, Shieh J-Y, Wang T-G, Hsieh F-J. Sonographic detection of occult fractures in the foot and ankle. Journal of Clinical Ultrasound. 1999 1999/10/01;27(8):421-5.
Bodner G, Stockl B, Fierlinger A, Schocke M, Bernathova M. Sonographic findings in stress fractures of the lower limb: preliminary findings. European radiology. 2005 Feb;15(2):356-9. PubMed PMID: 15503040. Epub 2004/10/27. eng.
Banal F, Etchepare F, Rouhier B, Rosenberg C, Foltz V, Rozenberg S, et al. Ultrasound ability in early diagnosis of stress fracture of metatarsal bone. Annals of the rheumatic diseases. 2006 Jul;65(7):977-8. PubMed PMID: 16769791. Pubmed Central PMCID: PMC1798191. Epub 2006/06/14. eng.
Bolvardi E, Rad MP, Abbasi B, R A. Is Bedside Ultrasound a Reliable Method for Detecting Soft Tissue Foreign Bodies in Upper Extremity Penetrating Trauma Patients? . Razavi International Journal of Medicine. 2014;2(4):e22070. En.
Abbasi B, Pezeshki-Rad M, Akhavan R, Sahebari M. Association between clinical and sonographic synovitis in patients with painful knee osteoarthritis. International journal of rheumatic diseases. 2017 May;20(5):561-6. PubMed PMID: 26915050. Epub 2016/02/26. eng.
Battaglia PJ, Kaeser MA, Kettner NW. Diagnosis and serial sonography of a proximal fifth metatarsal stress fracture. Journal of Chiropractic Medicine. 2013 2013/09/01/;12(3):196-200.
Roehrig GJ, McFarland EG, Cosgarea AJ, Martire JR, Farmer KW. Unusual Stress Fracture of the Fifth Metatarsal in a Basketball Player. Clinical Journal of Sport Medicine. 2001;11(4).
Atilla OD, Yesilaras M, Kilic TY, Tur FC, Reisoglu A, Sever M, et al. The accuracy of bedside ultrasonography as a diagnostic tool for fractures in the ankle and foot. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2014 Sep;21(9):1058-61. PubMed PMID: 25269589. Epub 2014/10/02. eng.
Ekinci S, Polat O, GÃ¼nalp M, Demirkan A, Koca A. The accuracy of ultrasound evaluation in foot and ankle trauma. The American Journal of Emergency Medicine. 2013 2013/11/01/;31(11):1551-5.
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