Role of targeted ultrasound for the diagnosis of rib fracture, a comparative study with plain x-ray

Abstract

Background and objective: Thoracic injuries are a common presentation in emergency hospitals in the Kurdistan region, mainly caused by road traffic accidents. Early and accurate diagnosis of rib fractures is essential in saving lives and preventing complications. The objective was to assess the validity of ultrasound in the diagnosis of rib fractures in comparison to plain x-ray. Methods: Present study was a cross-sectional study carried out in the Emergency department of Rozhalat Hospital in Erbil city-Kurdistan region/Iraq over ten months, from August 2021 to May 2022, on a sample of fifty-five (55) patients with suspected rib fractures. Rib fractures were diagnosed by the researcher based on clinical, ultrasound, and x-ray findings, and the findings of rib fracture were confirmed by CT-scan. All imaging methods were done at the Radiology department of Rozhalat hospital. Results: The validity findings of ultrasound examination taking CT scan as the gold standard was as follow: (97.7% sensitivity, 63.6% specificity, and 90.0% accuracy), while the validity findings of x-ray examination taking CT scan as the gold standard were (56.8% sensitivity, 54.5% specificity and 56.3% accuracy). The validity of ultrasound in detecting cortical disruption or hematoma was (93.8% sensitivity, 43.6% specificity, and 58.1% accuracy), while the validity of CXR in the detection of displacement was (31.3% sensitivity, 84.6% specificity, and 48.7% accuracy). Conclusion: Sonograph is an accurate diagnostic tool for detecting rib fracture with superior validity compared to a chest x-ray.