Acute knee trauma: role of ultrasound
The purpose of this study was to determine the diagnostic accuracy of high spatial resolution ultrasonography (US) in the detection of lipohemarthrosis of the knee and to evaluate this sign as criteria of intra-articular fracture. Forty-eight patients with clinical suspicion of knee fracture were pr...
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| Veröffentlicht in: | European radiology 2006-11, Vol.16 (11), p.2542-2548 |
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| creator | Bonnefoy, Olivier Diris, Benoît Moinard, Maryse Aunoble, Stéphane Diard, François Hauger, Olivier |
| description | The purpose of this study was to determine the diagnostic accuracy of high spatial resolution ultrasonography (US) in the detection of lipohemarthrosis of the knee and to evaluate this sign as criteria of intra-articular fracture. Forty-eight patients with clinical suspicion of knee fracture were prospectively examined by conventional radiography, sonography examination and computed tomography (CT) within 48 h after trauma in order to depict direct (fracture line) and indirect (lipohemarthrosis) signs of intra-articular fracture. Lipohemarthrosis was defined as a multi-layered collection in the subquadricipital recess. CT was considered as the gold standard for both direct and indirect fracture criteria. CT imaging showed direct signs of intra-articular fracture in 31 patients (65%). Among these patients, 30 (97%) had a lipohemarthrosis. Conventional radiographs showed intra-articular fracture in 26 patients (54%). Among these, 18 (69%) had a lipohemarthrosis. Sonographic examinations could not depict any direct sign of intra-articular fracture but showed a lipohemarthrosis in 29 (93%) of patients with proven fracture via CT. This allowed the depiction of four out of five occult knee fractures. The sensitivity, specificity, positive predictive value, negative predictive value of sonography for the diagnosis of lipohemarthrosis was 97, 100, 100 and 94%, respectively, compared with 55, 100, 100 and 55% with conventional radiographs. Using lipohemarthrosis as criterion of fracture, the sensitivity, specificity, positive predictive value and negative predictive value of sonography for early detection of intra-articular knee fractures was 94, 94, 97 and 89%, respectively, compared with 84, 88, 93 and 75% with conventional radiographs. We concluded that, by showing lipohemarthrosis in the subquadricipital recess, high-resolution sonography is a reliable and accurate technique for the evaluation of intra-articular knee fractures. |
| doi_str_mv | 10.1007/s00330-006-0319-x |
| format | Article |
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Forty-eight patients with clinical suspicion of knee fracture were prospectively examined by conventional radiography, sonography examination and computed tomography (CT) within 48 h after trauma in order to depict direct (fracture line) and indirect (lipohemarthrosis) signs of intra-articular fracture. Lipohemarthrosis was defined as a multi-layered collection in the subquadricipital recess. CT was considered as the gold standard for both direct and indirect fracture criteria. CT imaging showed direct signs of intra-articular fracture in 31 patients (65%). Among these patients, 30 (97%) had a lipohemarthrosis. Conventional radiographs showed intra-articular fracture in 26 patients (54%). Among these, 18 (69%) had a lipohemarthrosis. Sonographic examinations could not depict any direct sign of intra-articular fracture but showed a lipohemarthrosis in 29 (93%) of patients with proven fracture via CT. This allowed the depiction of four out of five occult knee fractures. The sensitivity, specificity, positive predictive value, negative predictive value of sonography for the diagnosis of lipohemarthrosis was 97, 100, 100 and 94%, respectively, compared with 55, 100, 100 and 55% with conventional radiographs. Using lipohemarthrosis as criterion of fracture, the sensitivity, specificity, positive predictive value and negative predictive value of sonography for early detection of intra-articular knee fractures was 94, 94, 97 and 89%, respectively, compared with 84, 88, 93 and 75% with conventional radiographs. We concluded that, by showing lipohemarthrosis in the subquadricipital recess, high-resolution sonography is a reliable and accurate technique for the evaluation of intra-articular knee fractures.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-006-0319-x</identifier><identifier>PMID: 16786321</identifier><language>eng</language><publisher>Germany: Springer Nature B.V</publisher><subject>Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Computed tomography ; Criteria ; Female ; Femoral Fractures - complications ; Femoral Fractures - diagnostic imaging ; Femoral Fractures - pathology ; Fractures ; Fractures, Closed - complications ; Fractures, Closed - diagnostic imaging ; Fractures, Closed - pathology ; Hemarthrosis - diagnostic imaging ; Hemarthrosis - etiology ; High resolution ; Humans ; Injury Severity Score ; Knee ; Knee Injuries - complications ; Knee Injuries - diagnostic imaging ; Knee Injuries - pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multilayers ; Predictive Value of Tests ; Prospective Studies ; Radiographs ; Radiography ; Research Design ; Sensitivity ; Sensitivity and Specificity ; Spatial discrimination ; Spatial resolution ; Tibial Fractures - complications ; Tibial Fractures - diagnostic imaging ; Tibial Fractures - pathology ; Tomography, X-Ray Computed ; Trauma ; Ultrasonic imaging ; Ultrasonography, Interventional</subject><ispartof>European radiology, 2006-11, Vol.16 (11), p.2542-2548</ispartof><rights>Springer-Verlag 2006.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c327t-86258d8252051a954519d53ee1aff74cbf429f5a50ed240a8859fa7628e3a0503</citedby><cites>FETCH-LOGICAL-c327t-86258d8252051a954519d53ee1aff74cbf429f5a50ed240a8859fa7628e3a0503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16786321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bonnefoy, Olivier</creatorcontrib><creatorcontrib>Diris, Benoît</creatorcontrib><creatorcontrib>Moinard, Maryse</creatorcontrib><creatorcontrib>Aunoble, Stéphane</creatorcontrib><creatorcontrib>Diard, François</creatorcontrib><creatorcontrib>Hauger, Olivier</creatorcontrib><title>Acute knee trauma: role of ultrasound</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><description>The purpose of this study was to determine the diagnostic accuracy of high spatial resolution ultrasonography (US) in the detection of lipohemarthrosis of the knee and to evaluate this sign as criteria of intra-articular fracture. Forty-eight patients with clinical suspicion of knee fracture were prospectively examined by conventional radiography, sonography examination and computed tomography (CT) within 48 h after trauma in order to depict direct (fracture line) and indirect (lipohemarthrosis) signs of intra-articular fracture. Lipohemarthrosis was defined as a multi-layered collection in the subquadricipital recess. CT was considered as the gold standard for both direct and indirect fracture criteria. CT imaging showed direct signs of intra-articular fracture in 31 patients (65%). Among these patients, 30 (97%) had a lipohemarthrosis. Conventional radiographs showed intra-articular fracture in 26 patients (54%). Among these, 18 (69%) had a lipohemarthrosis. Sonographic examinations could not depict any direct sign of intra-articular fracture but showed a lipohemarthrosis in 29 (93%) of patients with proven fracture via CT. This allowed the depiction of four out of five occult knee fractures. The sensitivity, specificity, positive predictive value, negative predictive value of sonography for the diagnosis of lipohemarthrosis was 97, 100, 100 and 94%, respectively, compared with 55, 100, 100 and 55% with conventional radiographs. Using lipohemarthrosis as criterion of fracture, the sensitivity, specificity, positive predictive value and negative predictive value of sonography for early detection of intra-articular knee fractures was 94, 94, 97 and 89%, respectively, compared with 84, 88, 93 and 75% with conventional radiographs. We concluded that, by showing lipohemarthrosis in the subquadricipital recess, high-resolution sonography is a reliable and accurate technique for the evaluation of intra-articular knee fractures.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Computed tomography</subject><subject>Criteria</subject><subject>Female</subject><subject>Femoral Fractures - complications</subject><subject>Femoral Fractures - diagnostic imaging</subject><subject>Femoral Fractures - pathology</subject><subject>Fractures</subject><subject>Fractures, Closed - complications</subject><subject>Fractures, Closed - diagnostic imaging</subject><subject>Fractures, Closed - pathology</subject><subject>Hemarthrosis - diagnostic imaging</subject><subject>Hemarthrosis - etiology</subject><subject>High resolution</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Knee</subject><subject>Knee Injuries - complications</subject><subject>Knee Injuries - diagnostic imaging</subject><subject>Knee Injuries - pathology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multilayers</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Radiographs</subject><subject>Radiography</subject><subject>Research Design</subject><subject>Sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Spatial discrimination</subject><subject>Spatial resolution</subject><subject>Tibial Fractures - complications</subject><subject>Tibial Fractures - diagnostic imaging</subject><subject>Tibial Fractures - pathology</subject><subject>Tomography, X-Ray Computed</subject><subject>Trauma</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Interventional</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkE1LAzEQhoMotlZ_gBdZEL1FZ_Kxm3grxS8oeNFzSHcTaN2PmmxA_70pLQieBobnfZl5CLlEuEOA6j4CcA4UoKTAUdPvIzJFwRlFUOKYTEFzRSutxYScxbgBAI2iOiUTLCtVcoZTcjOv0-iKz965Ygw2dfahCEPrisEXqc2bOKS-OScn3rbRXRzmjHw8Pb4vXujy7fl1MV_SmrNqpKpkUjWKSQYSrZZCom4kdw6t95WoV14w7aWV4BomwColtbdVyZTjFiTwGbnd927D8JVcHE23jrVrW9u7IUVT6vyxQpXB63_gZkihz7cZjqxUApCJTOGeqsMQY3DebMO6s-HHIJidQbM3aLJBszNovnPm6tCcVp1r_hIHZfwXWQ5o2Q</recordid><startdate>20061101</startdate><enddate>20061101</enddate><creator>Bonnefoy, Olivier</creator><creator>Diris, Benoît</creator><creator>Moinard, Maryse</creator><creator>Aunoble, Stéphane</creator><creator>Diard, François</creator><creator>Hauger, Olivier</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20061101</creationdate><title>Acute knee trauma: role of ultrasound</title><author>Bonnefoy, Olivier ; Diris, Benoît ; Moinard, Maryse ; Aunoble, Stéphane ; Diard, François ; Hauger, Olivier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c327t-86258d8252051a954519d53ee1aff74cbf429f5a50ed240a8859fa7628e3a0503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Computed tomography</topic><topic>Criteria</topic><topic>Female</topic><topic>Femoral Fractures - complications</topic><topic>Femoral Fractures - diagnostic imaging</topic><topic>Femoral Fractures - pathology</topic><topic>Fractures</topic><topic>Fractures, Closed - complications</topic><topic>Fractures, Closed - diagnostic imaging</topic><topic>Fractures, Closed - pathology</topic><topic>Hemarthrosis - diagnostic imaging</topic><topic>Hemarthrosis - etiology</topic><topic>High resolution</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Knee</topic><topic>Knee Injuries - complications</topic><topic>Knee Injuries - diagnostic imaging</topic><topic>Knee Injuries - pathology</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multilayers</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Radiographs</topic><topic>Radiography</topic><topic>Research Design</topic><topic>Sensitivity</topic><topic>Sensitivity and Specificity</topic><topic>Spatial discrimination</topic><topic>Spatial resolution</topic><topic>Tibial Fractures - complications</topic><topic>Tibial Fractures - diagnostic imaging</topic><topic>Tibial Fractures - pathology</topic><topic>Tomography, X-Ray Computed</topic><topic>Trauma</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bonnefoy, Olivier</creatorcontrib><creatorcontrib>Diris, Benoît</creatorcontrib><creatorcontrib>Moinard, Maryse</creatorcontrib><creatorcontrib>Aunoble, Stéphane</creatorcontrib><creatorcontrib>Diard, François</creatorcontrib><creatorcontrib>Hauger, Olivier</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bonnefoy, Olivier</au><au>Diris, Benoît</au><au>Moinard, Maryse</au><au>Aunoble, Stéphane</au><au>Diard, François</au><au>Hauger, Olivier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute knee trauma: role of ultrasound</atitle><jtitle>European radiology</jtitle><addtitle>Eur Radiol</addtitle><date>2006-11-01</date><risdate>2006</risdate><volume>16</volume><issue>11</issue><spage>2542</spage><epage>2548</epage><pages>2542-2548</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>The purpose of this study was to determine the diagnostic accuracy of high spatial resolution ultrasonography (US) in the detection of lipohemarthrosis of the knee and to evaluate this sign as criteria of intra-articular fracture. Forty-eight patients with clinical suspicion of knee fracture were prospectively examined by conventional radiography, sonography examination and computed tomography (CT) within 48 h after trauma in order to depict direct (fracture line) and indirect (lipohemarthrosis) signs of intra-articular fracture. Lipohemarthrosis was defined as a multi-layered collection in the subquadricipital recess. CT was considered as the gold standard for both direct and indirect fracture criteria. CT imaging showed direct signs of intra-articular fracture in 31 patients (65%). Among these patients, 30 (97%) had a lipohemarthrosis. Conventional radiographs showed intra-articular fracture in 26 patients (54%). Among these, 18 (69%) had a lipohemarthrosis. Sonographic examinations could not depict any direct sign of intra-articular fracture but showed a lipohemarthrosis in 29 (93%) of patients with proven fracture via CT. This allowed the depiction of four out of five occult knee fractures. The sensitivity, specificity, positive predictive value, negative predictive value of sonography for the diagnosis of lipohemarthrosis was 97, 100, 100 and 94%, respectively, compared with 55, 100, 100 and 55% with conventional radiographs. Using lipohemarthrosis as criterion of fracture, the sensitivity, specificity, positive predictive value and negative predictive value of sonography for early detection of intra-articular knee fractures was 94, 94, 97 and 89%, respectively, compared with 84, 88, 93 and 75% with conventional radiographs. We concluded that, by showing lipohemarthrosis in the subquadricipital recess, high-resolution sonography is a reliable and accurate technique for the evaluation of intra-articular knee fractures.</abstract><cop>Germany</cop><pub>Springer Nature B.V</pub><pmid>16786321</pmid><doi>10.1007/s00330-006-0319-x</doi><tpages>7</tpages></addata></record> |
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| subjects | Acute Disease Adolescent Adult Aged Aged, 80 and over Computed tomography Criteria Female Femoral Fractures - complications Femoral Fractures - diagnostic imaging Femoral Fractures - pathology Fractures Fractures, Closed - complications Fractures, Closed - diagnostic imaging Fractures, Closed - pathology Hemarthrosis - diagnostic imaging Hemarthrosis - etiology High resolution Humans Injury Severity Score Knee Knee Injuries - complications Knee Injuries - diagnostic imaging Knee Injuries - pathology Magnetic Resonance Imaging Male Middle Aged Multilayers Predictive Value of Tests Prospective Studies Radiographs Radiography Research Design Sensitivity Sensitivity and Specificity Spatial discrimination Spatial resolution Tibial Fractures - complications Tibial Fractures - diagnostic imaging Tibial Fractures - pathology Tomography, X-Ray Computed Trauma Ultrasonic imaging Ultrasonography, Interventional |
| title | Acute knee trauma: role of ultrasound |
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