[Pediatric fracture diagnosis--ultra-low-dose CT with an effective dose equal to that of radiographs]. / Pädiatrische Frakturdiagnostik--Ultra-low-dose-CT mit der effektiven Dosis von Röntgenaufnahmen.

PURPOSE: Computed tomography (CT) plays an important role in trauma diagnosis in children, especially for complex fractures. The aim of this study was to examine the diagnostic value of ultra-low-dose-CT (ULD-CT) with an effective dose equal to that of radiographs in an experimental study and to compare its results with those of radiographs. MATERIALS AND METHODS: Limb bones of dead young pigs served as a model for pediatric bones. A total of 51 fractured and non-fractured bones were examined with a 64 multislice-CT with a standard dose protocol as gold standard, with two ultra-low-dose-protocols, and with standard radiographs with different exposures. RESULTS: In spite of high background noise the examinations of ULD-CT were not adequate only in 2 of 204 cases. ULD-CT was slightly superior to radiographs in detection of fractures. ULD-CT could significantly better characterize the fractures than radiographs. The overall result of ULD-CT was significantly better than that of radiographs with standard exposure. CONCLUSION: ULD-CT with the effective dose of radiographs is successfully applicable in pediatric fracture diagnosis, and its overall result is significantly better than that of radiographs.

[Is ultrasound equal to X-ray in pediatric fracture diagnosis?]. / Ist die Sonografie der Röntgendiagnostik in der pädiatrischen Frakturdiagnostik gleichwertig?

PURPOSE: Ultrasound is currently not established for the diagnosis of fractures. The aim of this study was to compare ultrasound and X-ray beyond their use solely for the identification of fractures, i. e., for the detection of fracture type and dislocation for pediatric fracture diagnosis. MATERIALS AND METHODS: Limb bones of dead young pigs served as a model for pediatric bones. The fractured bones were examined with ultrasound, X-ray, and CT, which served as the gold standard. RESULTS: 162 of 248 bones were fractured. 130 fractures were identified using ultrasound, and 148 using X-ray. There were some advantages of X-ray over ultrasound in the detection of fracture type (80 correct results using X-ray, 66 correct results using ultrasound). Ultrasound, however, was superior to X-ray for dislocation identification (41 correct results using X-ray, 51 correct results using ultrasound). Both findings were not statistically significant after adjustment for multiple testing. CONCLUSION: Ultrasound not only has comparable sensitivity to that of X-ray for the identification of limb fractures but is also equally effective for the diagnosis of fracture type and dislocation. Thus, ultrasound can be used as an adequate alternative method to X-ray for pediatric fracture diagnosis.