The role of ultrasonography in the diagnosis of rib fractures

Background: Background: Rib fractures rank among the most common conditions in thoracic traumas. Chest radiography is often insufficient for diagnosing rib fractures. Therefore, the study aimed to evaluate the success of thoracic ultrasonography (US) in diagnosing rib fractures. Materials and Methods: Patients over 18 years of age who were hospitalized in our clinic due to traumarelated rib fractures between 2022 and 2023, were included. All patients had chest radiography and computed tomography (CT) scans during their emergency admission, as per the routine operation of the emergency department. Chest radiography and CT images were evaluated by the thoracic surgery clinic, and CT images were also examined through the radiology reports. Thoracic US was performed on all patients by the same radiologist the day after admission to the clinic. The patient's demographic characteristics, chest radiography, chest CT, and thoracic US findings were recorded, and the data were compared statistically. Results: A total of 58 cases were included in the study, 42 (72.4%) males and 16 (27.6%) females. The mean age of the study population was 60.55 ± 15.71 years. When evaluated regarding trauma types, 42 (72.4%) patients had a fall, 15 (25.9%) had a traffic accident, and 1 (1.7%) patient had a history of battery. In addition to rib fractures, hemothorax was detected in 67.2% of the cases, pneumothorax in 27.6%, and pulmonary contusion in 19.0%. In radiological imaging, while 246 rib fractures were reported according to CT, 136 rib fractures were detected in USG and 140 in direct radiography. Considering CT imaging is the gold standard, 114 of 246 rib fractures (46.3%) could be detected with ultrasound imaging, while 127 (51.6%) were determined with direct radiography. Conclusions: When chest CT is considered the gold standard, direct radiography, and thoracic US have no general superiority over each other.