• Am J Emerg Med · Mar 2022

    Sensitivity and specificity of waterbath ultrasound technique in comparison to the conventional methods in diagnosing extremity fractures.

    • Prawal Shrimal, Sanjeev Bhoi, Tej Prakash Sinha, L R Murmu, Jamshed Nayer, Meera Ekka, Prakash Mishra, Akshay Kumar, Vivek Trikha, and Praveen Aggarwal.
    • Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.
    • Am J Emerg Med. 2022 Mar 1; 53: 118-121.

    IntroductionPoint of care ultrasound (POCUS) has variable diagnostic accuracy in diagnosing fractures. Waterbath technique is a modification of the conventional ultrasound technique which may improve diagnostic accuracy by enhancing image quality. Authors studied the diagnostic accuracy of waterbath technique compared to the final diagnosis based on clinical examination and radiology in the identification of fractures of hand and foot.MethodsPatients of >18 yrs. age with suspected distal hand and foot fractures presenting to the emergency department of a level 1 trauma center were recruited after informed consent. Unconscious and hemodynamically unstable patients, injuries >72 h old, open fractures, obvious deformities, and old fractures at the affected site were excluded. Cases were subjected to waterbath technique performed by an academic emergency medicine resident and relevant radiographs were ordered and interpreted by an orthopedic specialist. CT/MRI, if done in case of discrepancy, was interpreted by radiologist. The findings of both waterbath technique and radiology were blinded to each other and compared to the final diagnosis made by a cumulative assessment of clinical examination, radiographs, and CT/MRI of the discrepant cases.ResultsWaterbath technique identified fractures of hand and foot with sensitivity of 97% (95% CI 90%-100%), specificity 94% (95%CI 81%-99%), PPV 98% (95%CI 91%-99%), NPV 94% (95%CI 79%-98%), LR+ 17.5(95% CI 4.5-67.2), LR- 0.03(95% CI 0.01-0.12) and diagnostic accuracy 96% (95%CI 91%-99%).ConclusionThis pilot study has demonstrated the utility of Waterbath technique in the diagnosis of fractures of hand and foot in adults in the ED setting. Future well designed studies are required to explore the potential of this novel technique in both adult and pediatric population.Copyright © 2022 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…