The comparison of bedside point-of-care ultrasound and computed tomography in elbow injuries

The objective of the study was to compare the efficacy of point-of-care ultrasound (POCUS) and computed tomography (CT) in the diagnosis of the fracture of the bones that form the elbow joint and the determination of treatment method in elbow injuries.

Forty-nine patients aged 5 to 65 years, who were admitted with low-energy elbow injuries, had at least 1 fracture of the elbow joint bones, and underwent CT scanning, were included in this study. Before the initiation of the study, orthopedic surgeons and emergency physicians determined a common treatment based on the fracture characteristics. Patients were first evaluated with direct radiography, and then with POCUS by trained emergency physicians. Emergency physicians made treatment decisions based on the ultrasonography results. Then, CT scans were performed. The CT images were interpreted by radiologists. Orthopedic surgeons made treatment decisions based on the CT interpretations.

Forty-nine patients with elbow injury were included in the study. Eighteen (37%) patients were women, and 31 (63%) were men. The mean age was 21 ± 15 years. Compared with CT, sensitivity, specificity, positive predictive value, and negative predictive value of POCUS in fracture detection were 97%, 88%, 94%, and 93%, respectively. Although the sensitivity and specificity of POCUS in the decision for reduction were 95% and 100%, respectively, it was 93% and 100% in the decision for surgery.

In conclusion, POCUS was shown to be successfully applied in the diagnosis and management of elbow injuries, in which direct radiography was inefficient and CT scans were required.