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Detection of Traumatic Knee Arthrotomy in Children Using Point-of-Care Ultrasound, a Review of 2 Cases
Blake Nowakowski1, Antonio Riera2
1Yale New Haven Hospital.
Insights
Point-of-care ultrasound (POCUS) effectively diagnosed traumatic knee arthrotomy in two pediatric patients with penetrating knee injuries. This imaging method proved low-risk and efficient for identifying trapped air in the knee joint.
Area of Science:
- Pediatric Orthopedics
- Emergency Medicine
- Diagnostic Imaging
Background:
- Traumatic knee injuries in children can lead to arthrotomy, requiring prompt diagnosis.
- Limited data exists on the utility of point-of-care ultrasound (POCUS) for pediatric traumatic knee arthrotomy.
- POCUS is recognized as a safe and efficient imaging modality for various conditions.
Purpose of the Study:
- To evaluate the effectiveness of POCUS in diagnosing traumatic knee arthrotomy in pediatric patients.
- To highlight POCUS as a potential diagnostic tool in the pediatric emergency setting for knee injuries.
Main Methods:
- Case report of two pediatric patients with penetrating knee trauma.
- Point-of-care ultrasound (POCUS) was performed to assess knee joint pathology.
- Further imaging and surgical evaluation (irrigation and debridement) were conducted.
Main Results:
- POCUS revealed trapped air in the suprapatellar bursa in both cases, consistent with arthrotomy.
- The diagnosis was confirmed, leading to urgent surgical intervention.
- POCUS provided rapid and accurate diagnostic information.
Conclusions:
- POCUS is a valuable, low-risk, and efficient tool for diagnosing traumatic knee arthrotomy in pediatric emergency departments.
- This case series supports the expanded use of POCUS in pediatric orthopedic emergencies.
- Further research is warranted to establish POCUS protocols for traumatic knee injuries in children.
Abstract:
These 2 cases involved children who suffered traumatic penetrating injuries to the knee and were ambulatory after the event. Point-of-care ultrasound (POCUS) performed on both patients revealed findings consistent with trapped air in the suprapatellar bursa. Both patients were evaluated with additional imaging and were treated by pediatric orthopedic surgeons for urgent operative irrigation and debridement. There is limited data on the use of POCUS for traumatic knee arthrotomy, especially among pediatric populations. Ultrasound has been well established as a safe and timely imaging modality in a variety of other conditions. In these cases, POCUS represented a low-risk and efficient approach for the diagnosis of traumatic knee arthrotomy in the pediatric emergency department.
