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Updated: Feb 5, 2026
Assessment of Bone Fracture Healing Using Micro-Computed Tomography
Published on: December 9, 2022
Comparing ultrasonography with plain radiography in the diagnosis of paediatric long-bone fractures
Akinola Akinmade1, Innocent Ikem2, Oluwagbemiga Ayoola2
1Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria. akinzo01@yahoo.com.
Insights
Ultrasonography shows high accuracy in diagnosing pediatric fractures, offering a safer alternative to X-rays. This imaging technique also detects fracture healing earlier than conventional radiography.
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
- Musculoskeletal Ultrasound
Background:
- Conventional radiography is standard for pediatric long-bone fracture diagnosis but involves ionizing radiation.
- Ultrasonography presents a safer, potentially more accessible, and user-friendly alternative.
- This study evaluates ultrasound's utility in pediatric fracture diagnosis compared to radiography.
Purpose of the Study:
- To assess the applicability of ultrasound scanning versus plain radiography for diagnosing pediatric fractures.
- To compare the diagnostic accuracy and efficiency of both imaging modalities.
Main Methods:
- Prospective observational study comparing plain radiographs and ultrasound assessments of pediatric fractures.
- Inclusion of 62 subjects aged 1-15 years.
- Evaluation of sensitivity, specificity, and predictive values; follow-up scans at 3 and 6 weeks for treatment monitoring.
Main Results:
- Ultrasound identified 50 out of 52 fractures diagnosed by radiography (96.2% sensitivity).
- Ultrasound demonstrated 100% specificity, positive predictive value, and 83.3% negative predictive value.
- Callus formation was detected earlier with ultrasound than with radiography.
Conclusions:
- Ultrasound is a promising tool for diagnosing pediatric fractures, though it may have limitations with metaphyseal bone fractures.
- Its ability to detect early callus formation makes ultrasonography valuable for monitoring fracture healing.
Purpose:
Paediatric long-bone fractures are commonly seen in the emergency department, and diagnosis is usually confirmed by conventional radiographs. This entails exposure to ionizing radiation with its attendant possible carcinogenic and teratogenic effects. Ultrasonography provides a potentially safer diagnostic alternative and may be cheaper, more readily available, and user-friendly. This study aimed to establish the applicability of ultrasound scanning compared with plain radiography in fracture diagnosis.
Methods:
This prospective observational study documented fracture characteristics using plain radiographs and compared these with findings on ultrasound assessment of same fractures at the time of injury. Scans were repeated at week three and week six to monitor treatment in those whom the mode of treatment did not preclude scanning. Outcome measures were compared for relationships including sensitivity and specificity as well as overall predictive values.
Results:
The age range of the 62 subjects enrolled was one to 15 years and the male to female ratio was 1.8:1. Plain radiographs diagnosed 52 fractures and 50 of these were recognized on ultrasound. The two false-negative ultrasound scans were noted in metaphyseal humeral fractures. Overall sensitivity, specificity, and positive and negative predictive values for ultrasonography were 96.2%, 100%, 100%, and 83.3% respectively. Ultrasound scans were also noted to identify callus formation significantly earlier than plain radiographs.
Conclusion:
Ultrasound shows potential as a tool in diagnosis of paediatric fractures but may be limited in fractures around metaphyseal bone. Due to the ability to detect callus formation much earlier, ultrasonography may be very useful in monitoring of fracture healing.
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