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Diagnosing broken bones without radiation: Ultrasound can often replace x-rays
If there is suspicion of a broken bone, x-ray procedures have so far often been the first means of choice. However, the health risks of these examinations should not be underestimated. Children in particular are very sensitive to radiation exposure because their body is still growing. A new study now shows that radiation-free ultrasound diagnostics can often replace x-rays.
Gentle ultrasound diagnostics often offer equivalent results
If a broken bone is suspected, x-ray procedures have so far often been the first means of choice. However, as confirmed by a current meta-analysis in which data from the past ten years have been evaluated, the radiation-free, gentle ultrasound diagnostics in many cases offer equivalent results. Experts from the German Society for Ultrasound in Medicine (DEGUM) therefore recommend that ultrasound be used to diagnose fractures whenever possible and promising.
Children are significantly more sensitive to X-ray exposure
For children in particular, it has repeatedly been recommended in recent years to use ultrasound and MRI instead of X-rays and CT.
Sonography is particularly recommended for childhood fractures, because this age group is about ten times more sensitive to X-rays than adults.
“It is a good idea to use ultrasound routinely for wrist fractures in children. In this way, with the same accuracy, 80 percent of the X-ray exposure can be saved, ”explains Privatdozent Dr. med. Ole Ackermann, senior physician in the department of trauma surgery and orthopedics at the Evangelisches Krankenhaus Mettmann, in a communication from DEGUM.
Sonography should be the first choice
Even if the small patients are suspected of having broken an elbow or an upper arm, sonography should be the first choice.
Fractures of the ribs and sternum, as well as fractures of the extremities of the legs, such as the femur and the spine and fibula, should also be diagnosed generously sonographically in both children and adults.
The current meta-analysis published in the "Deutsches Ärzteblatt" "Diagnosis of suspected fractures - ultrasound compared to conventional imaging" shows that the fractures mentioned can be detected with ultrasound as reliably as with the X-ray method.
Safe alternative to x-rays in children
Ultrasound diagnostics has many advantages over the X-ray procedure: "Ultrasound diagnostics are radiation-free and therefore much gentler on the patient," says Ackermann, who is a member of the DEGUM working group on movement organs.
Dr. Bernd Schweiger from the University Hospital Essen sees it similarly. In a communication from the German Roentgen Society (DRG) on the topic "Ultrasound for broken bones - a safe alternative to X-rays in children", the doctor explains:
"Through the sensible use of ultrasound, in addition to significantly accelerating the diagnostic examination, a significant reduction in the medically caused radiation exposure in children can be achieved."
In addition, according to DEGUM, the process can be carried out cost-effectively. Another advantage over X-ray diagnostics is that ultrasound devices are often more readily available - not only in emergency rooms, but also in many practices.
However, this requires the corresponding know-how both in “sounding” and in interpreting the findings.
Although doctors are good at acquiring the skills required, patients with suspected bone fracture are still exposed to X-rays far too often.
The reason: "So far, health insurance companies have not paid for ultrasound examinations for broken bones," Ackermann complains. "It has to change urgently in the interest of the patients." (Ad)